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

Ebele N Iloabachie

Individual provider Family Nurse Practitioner · NPI 1093050841

Ebele N Iloabachie is a Nurse Practitioner in Fairview Heights, Illinois. Qualified in 2012, 14 years ago. Practices with Promed Preferred Il 2 PLLC, a 15-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Missouri.

Years since qualifying
14
Licensed in
IL, MO
In the registry since
2012
Specialties on file
4
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Practice location Address checks out

141 Market Pl Ste 100
Fairview Heights, IL 62208-2089
Phone: (618) 398-4226
Fax: (618) 398-1759
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3920 Hampton Ave, Saint Louis, MO 63109-1401 — (314) 687-2713
  • 12098 Lusher Rd, Saint Louis, MO 63138-1302 — (866) 825-3227

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 277003973 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209.010250 (IL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 2021048982 (MO)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2012036151 (MO)

Record details

NPI number1093050841
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 5, 2012
Last updated in NPPESMay 30, 2025
Certification dateMay 30, 2025
Mailing address7006 Stony Ridge Rd, Saint Louis, MO 63129-6405

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Promed Preferred Il 2 Pllc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fairview Heights