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General NPI Number Information
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NPI Number | 1700956695
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Entity Type | Individual
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Provider Name | DAVID ANYADIKE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2738 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60608-3528
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Country | US
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Telephone | 773-376-1906
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Fax | 773-376-1909
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Provider Business Mailing Address
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Address Line | 3037 W POLK STREET UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60612-3906
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Country | US
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Telephone | 773-826-6282
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Fax | 773-376-1909
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036109277
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License Number State | IL
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