Healthcare Provider Details

I. General information

NPI: 1144887738
Provider Name (Legal Business Name): CHINDIKA HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E 87TH ST STE 109
CHICAGO IL
60617-2706
US

IV. Provider business mailing address

PO BOX 806112
CHICAGO IL
60680-4122
US

V. Phone/Fax

Practice location:
  • Phone: 312-489-0103
  • Fax: 872-266-0204
Mailing address:
  • Phone: 312-489-0103
  • Fax: 872-266-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. OTUONYE EZERIBE ONYEWUCHI
Title or Position: MEDICAL DIRECTOR/CEO
Credential: MD
Phone: 312-489-0103