Healthcare Provider Details

I. General information

NPI: 1255022158
Provider Name (Legal Business Name): HENRY OKOROIKE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 838
CHICAGO IL
60612-3866
US

IV. Provider business mailing address

1000 S CLARK ST UNIT 1503
CHICAGO IL
60605-2194
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5020
  • Fax:
Mailing address:
  • Phone: 916-380-1289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0206X
TaxonomyCardiology Pharmacist
License Number051303971
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: