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General NPI Number Information
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NPI Number | 1407123433
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Entity Type | Organization
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Legal Business Name | CLARA AKHIGBE MD SC
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Dates
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Enumeration Date | 11/18/2011
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 6307 S STEWART AVE STE 313
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City | CHICAGO
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State | IL
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Zip | 60621-3116
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Country | US
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Telephone | 773-962-0633
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Fax | 773-994-2174
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Provider Business Mailing Address
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Address Line | 6307 S STEWART AVE STE 313
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City | CHICAGO
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State | IL
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Zip | 60621-3116
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Country | US
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Telephone | 773-962-0633
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Fax | 773-994-2174
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. CLARA AKHIGBE
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Credential | MD
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Telephone | 773-962-0633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 042617575
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License Number State | IL
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