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General NPI Number Information
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NPI Number | 1790161305
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Entity Type | Organization
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Legal Business Name | NNEKA E. ONYEZIA PHD, LLC
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 1030 N CLARK ST SUITE 300
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City | CHICAGO
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State | IL
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Zip | 60610-5467
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Country | US
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Telephone | 312-725-0225
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Fax |
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Provider Business Mailing Address
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Address Line | 659 W RANDOLPH ST APT 1020
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City | CHICAGO
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State | IL
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Zip | 60661-2151
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Country | US
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Telephone | 312-725-0225
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. NNEKA ESTELLE ONYEZIA
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Credential | PHD
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Telephone | 312-725-0225
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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 | 071008034
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License Number State | IL
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