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General NPI Number Information
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NPI Number | 1255256558
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Entity Type | Individual
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Provider Name | INYENE MAGDALENE UDOH LSW
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 56 E 47TH ST STE 525C
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City | CHICAGO
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State | IL
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Zip | 60653-3844
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Country | US
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Telephone | 773-828-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 N SHERIDAN RD APT 505
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City | CHICAGO
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State | IL
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Zip | 60640-3156
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Country | US
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Telephone | 704-756-8921
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.129935
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License Number State | IL
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