MEDICARE: IC HEALTH SERVICES INC

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

General Provider Information

NPI Number	:	1467349043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IC HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	8000 JUMPERS HOLE RD STE 223
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1036
Country	:	US
Telephone Number	:	301-793-0626
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 JUMPERS HOLE RD STE 223
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1036
Country	:	US
Telephone Number	:	443-620-3616
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHIDINMA JENNIFER ONYEGWU
Credential	:	DNP,PMHNP
Telephone Number	:	301-793-0626

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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Directions to “IC HEALTH SERVICES INC ” Practice Location

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