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NPI Code Detail

MEDICARE: DR. NKEIRUKA O. DARA M.D.

MEDICARE: DR. NKEIRUKA O. DARA M.D.
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
1207V00000XObstetrics & Gynecology Physician036122639IL

General Provider Information

NPI Number : 1679801476
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NKEIRUKA O. DARA M.D.
Provider Business Mailing Address
First Line : 2451 W HOWARD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60645-1521
Country : US
Telephone Number : 872-302-9909
Fax Number :
Provider Business Practice Location Address
First Line : 1555 W HOWARD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60626-1707
Country : US
Telephone Number : 773-265-0300
Fax Number : 773-265-8467
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2009
Last Update Date : 01/21/2021

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