Healthcare Provider Details

I. General information

NPI: 1013421304
Provider Name (Legal Business Name): TOCHI OKWUEZE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOCHI UDENZE

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 11/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N HIGHLAND AVE
AURORA IL
60506-3814
US

IV. Provider business mailing address

400 N HIGHLAND AVE
AURORA IL
60506-3814
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-2532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209016786
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: