Healthcare Provider Details

I. General information

NPI: 1275119562
Provider Name (Legal Business Name): NATOBE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WESTBROOK CORPORATE CTR STE 300
WESTCHESTER IL
60154-5709
US

IV. Provider business mailing address

PO BOX 3335
OAK BROOK IL
60522-3335
US

V. Phone/Fax

Practice location:
  • Phone: 312-970-0036
  • Fax: 949-561-4847
Mailing address:
  • Phone: 312-970-0036
  • Fax: 949-561-4847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHIEDZA NWAKUDU
Title or Position: NURSE PRACTITIONER
Credential: DNP, NP
Phone: 312-970-0036