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General NPI Number Information
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NPI Number | 1508470774
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Entity Type | Organization
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Legal Business Name | DR. ELOM AMUZU LLC
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 11/08/2020
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Provider Practice Location Address
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Address Line | 18237 KEDZIE AVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-1411
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Country | US
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Telephone | 708-299-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 18237 KEDZIE AVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-1411
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Country | US
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Telephone | 312-292-9753
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Fax |
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Authorized Official
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Title or Position | OWNER AND LICENSED PSYCHOLOGIST
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Name | DR. ELOM AMUZU
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Credential | PHD
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Telephone | 312-292-9753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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