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General NPI Number Information
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NPI Number | 1710606298
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Entity Type | Individual
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Provider Name | CHIBOGU VICTORIA OBIANWU PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1000 N. WESTMORELAND CANCER CENTER
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City | LAKE FOREST
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State | IL
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Zip | 60045
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Country | US
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Telephone | 847-535-6778
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Fax |
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Provider Business Mailing Address
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Address Line | 1512 ARTAIUS PKWY STE 102
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-5231
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Country | US
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Telephone | 847-847-2230
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Fax | 833-464-0923
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209025829
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 209025829
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License Number State | IL
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