Healthcare Provider Details

I. General information

NPI: 1518252386
Provider Name (Legal Business Name): FRANKLIN UDOKA NJOKU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SICKLE CELL CENTER 820 SOUTH WOOD STREET
CHICAGO IL
60612
US

IV. Provider business mailing address

7753 VAN BUREN ST UNIT 304
FOREST PARK IL
60130-1887
US

V. Phone/Fax

Practice location:
  • Phone: 205-253-0363
  • Fax:
Mailing address:
  • Phone: 205-253-0363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01074584A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036136679
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: