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

Prince Osazuwa Ehimamiegho, MD

Individual provider Family Medicine Physician · NPI 1497499719

Prince Osazuwa Ehimamiegho, MD is a Family Practice in Peoria, Illinois. Qualified in 2020, 6 years ago. Practices with Northbay Health Medical Foundation, a 202-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Illinois.

Years since qualifying
6
Licensed in
CA, IL
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

815 Main St Ste C
Peoria, IL 61602-1080
Phone: (309) 672-4977
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A202757 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036172524 (IL)

Record details

NPI number1497499719
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 22, 2022
Last updated in NPPESNovember 14, 2025
Certification dateNovember 14, 2025

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northbay Health Medical Foundation — 202 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Peoria