MEDICARE: CHINYERE AGINA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209029009	IL

General Provider Information

NPI Number	:	1225897085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINYERE AGINA

Provider Business Mailing Address
First Line	:	255 W 69TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60621-3767
Country	:	US
Telephone Number	:	773-440-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 W 69TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60621-3767
Country	:	US
Telephone Number	:	773-440-2150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2024
Last Update Date	:	03/15/2024

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Directions to “ CHINYERE AGINA ” Practice Location

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