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General NPI Number Information
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NPI Number | 1801143482
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Entity Type | Individual
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Provider Name | ONWUKAMIKE PATRICK NWANKPA DPM
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Gender | Male
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 1429 PITNER AVE
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City | EVANSTON
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State | IL
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Zip | 60201-3935
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Country | US
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Telephone | 773-407-5988
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Fax |
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Provider Business Mailing Address
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Address Line | 1429 PITNER AVE
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City | EVANSTON
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State | IL
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Zip | 60201-3935
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Country | US
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Telephone | 773-407-5988
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016005543
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 213EP0504X
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Taxonomy Name | Public Medicine Podiatrist
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License Number | 016005543
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 016005543
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number | 016005543
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016005543
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License Number State | IL
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