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General NPI Number Information
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NPI Number | 1588469969
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Entity Type | Individual
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Provider Name | EZINNE NWACHUKWU
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 5753 N CANFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60631-2206
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Country | US
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Telephone | 773-631-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 13209 LAGUNA SHORES DR
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City | PEARLAND
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State | TX
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Zip | 77584-6749
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Country | US
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Telephone | 346-237-0473
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.306844
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License Number State | IL
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