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General NPI Number Information
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NPI Number | 1376376848
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Entity Type | Organization
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Legal Business Name | AI CANCER THERAPEUTIX SC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 4700 N MARINE DR STE 315
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City | CHICAGO
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State | IL
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Zip | 60640-7976
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Country | US
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Telephone | 872-201-8479
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15250
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City | CHICAGO
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State | IL
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Zip | 60615-5143
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHUKWUEMEKA UZOKA
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Credential | MD
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Telephone | 407-870-3720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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