Chinelo Agwuncha, D.O.
Student in an Organized Health Care Education/Training Program in Maywood, IL. Individual provider (NPI-1).
NPI number1477304996
StatusActive
Last updated in NPPESApr 1, 2024
Details
- NPI
- 1477304996
- Entity type
- Individual (NPI-1)
- Name
- Chinelo Agwuncha
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 1, 2024
- Certification date
- Mar 25, 2024
- Last updated
- Apr 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | IL | Yes |
Practice location
2160 S 1st AveMaywood, IL 60153-3328
Phone 708-216-5140
Mailing address
2160 S 1st AveMaywood, IL 60153-3328
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