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General NPI Number Information
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NPI Number | 1114602760
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Entity Type | Organization
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Legal Business Name | INTUITIVE EXPRESSIONS LLC
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 4100 W OGDEN AVE
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City | CHICAGO
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State | IL
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Zip | 60623-2821
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Country | US
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Telephone | 312-405-8536
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 W OGDEN AVE
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City | CHICAGO
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State | IL
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Zip | 60623-2821
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Country | US
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Telephone | 312-405-8536
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Fax |
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Authorized Official
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Title or Position | VP
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Name | UMEKO JONES
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Credential | FNP
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Telephone | 312-405-8536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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