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NPI Code Detail

MEDICARE: JENNIFER F IWUCHUKWU CNM

MEDICARE:   JENNIFER F IWUCHUKWU  CNM
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
1367A00000XAdvanced Practice MidwifeIL

General Provider Information

NPI Number : 1801816707
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER F IWUCHUKWU CNM
Provider Business Mailing Address
First Line : 4544 SOUTH KING DRIVE
Second Line : 1ST FLR.
City : CHICAGO
State : IL
Zip : 60653-4115
Country : US
Telephone Number : 773-268-1020
Fax Number : 773-268-1020
Provider Business Practice Location Address
First Line : 1901 W HARRISON ST
Second Line : SUITE 4453
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-4184
Fax Number : 312-864-9369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 07/08/2007

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