Healthcare Provider Details

I. General information

NPI: 1811574643
Provider Name (Legal Business Name): MAUREEN IKPEAMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 TECHNY RD
NORTHBROOK IL
60062-5447
US

IV. Provider business mailing address

220 E ILLINOIS ST APT 2209
CHICAGO IL
60611-4486
US

V. Phone/Fax

Practice location:
  • Phone: 847-562-5612
  • Fax:
Mailing address:
  • Phone: 708-843-3559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036.181430
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: