Healthcare Provider Details

I. General information

NPI: 1992488209
Provider Name (Legal Business Name): IMANII UWAKWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 E 53RD ST STE 901
CHICAGO IL
60615-4572
US

IV. Provider business mailing address

4013 S DREXEL BLVD
CHICAGO IL
60653-2416
US

V. Phone/Fax

Practice location:
  • Phone: 312-767-8589
  • Fax:
Mailing address:
  • Phone: 312-609-9738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: