Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Chiagoziem Jane Ndulue, MD

Individual provider Family Medicine Physician · NPI 1780173864

Dr. Chiagoziem Jane Ndulue, MD is a Family Practice in O Fallon, Illinois. Qualified in 2014, 12 years ago. Practices with Southern Illinois Healthcare Foundation Inc, a 118-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois, North Carolina and Washington.

Years since qualifying
12
Licensed in
IL, NC, WA
In the registry since
2018
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone: (618) 233-5480
Fax: (618) 222-4792
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 930 3rd St, Greensboro, NC 27405-6967 — (336) 890-3200
  • 931 S. Market Blvd, Chehalis, WA 98532 — (360) 767-6300

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036171759 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 2023-00632 (NC)
Family Medicine Physician Taxonomy 207Q00000X · Licence ML60866561 (WA)

Record details

NPI number1780173864
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 4, 2018
Last updated in NPPESOctober 14, 2024
Certification dateOctober 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Southern Illinois Healthcare Foundation Inc — 118 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in O Fallon