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General NPI Number Information
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NPI Number | 1265324677
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Entity Type | Individual
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Provider Name | PRINCEWILL ONWENU
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Gender |
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 2511 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-3883
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Country | US
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Telephone | 773-772-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 641 W WAYMAN ST UNIT D
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City | CHICAGO
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State | IL
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Zip | 60661-1021
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Country | US
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Telephone | 248-732-9904
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019036266
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License Number State | IL
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