MEDICARE: DR. FRANCIS NNAWUGO NWAWUEZE

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	363LF0000X	Family Nurse Practitioner	209017588	IL

General Provider Information

NPI Number	:	1609365659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS NNAWUGO NWAWUEZE

Provider Business Mailing Address
First Line	:	59 DEERPATH RD
Second Line	:
City	:	MATTESON
State	:	IL
Zip	:	60443-1125
Country	:	US
Telephone Number	:	708-261-5213
Fax Number	:	708-748-4818

Provider Business Practice Location Address
First Line	:	8201 S ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620
Country	:	US
Telephone Number	:	773-873-3434
Fax Number	:	773-873-8201

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

Provider Enumeration Date	:	05/04/2018
Last Update Date	:	05/12/2018

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