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General NPI Number Information
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NPI Number | 1700102647
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Entity Type | Individual
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Provider Name | CHINYERE OKOROH FNP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 977 N OAKLAWN AVE SUITE 104
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City | ELMHURST
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State | IL
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Zip | 60126-1045
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Country | US
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Telephone | 630-832-1775
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Fax | 630-832-3078
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Provider Business Mailing Address
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Address Line | 15629 DREXEL AVE
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City | DOLTON
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State | IL
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Zip | 60419-2751
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Country | US
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Telephone | 708-261-2166
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.007787
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License Number State | IL
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