Healthcare Provider Details

I. General information

NPI: 1528408846
Provider Name (Legal Business Name): DR. EJIDIKE IHERIGBO NMEZI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2013
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 LINCOLN AVE
SKOKIE IL
60077-3695
US

IV. Provider business mailing address

7003 NIGHTINGALE TER
LANHAM MD
20706-3925
US

V. Phone/Fax

Practice location:
  • Phone: 800-553-7359
  • Fax: 847-588-7060
Mailing address:
  • Phone: 240-367-8887
  • Fax: 301-552-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH2311
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11905
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: