Healthcare Provider Details

I. General information

NPI: 1063162436
Provider Name (Legal Business Name): ADORA ILOCHONWU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10605 CONCORD ST STE 205
KENSINGTON MD
20895-2526
US

IV. Provider business mailing address

10605 CONCORD ST STE 205
KENSINGTON MD
20895-2526
US

V. Phone/Fax

Practice location:
  • Phone: 301-949-4242
  • Fax: 301-449-8041
Mailing address:
  • Phone: 301-949-4242
  • Fax: 301-949-8041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125080887
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0104607
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: