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General NPI Number Information
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NPI Number | 1952115057
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Entity Type | Individual
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Provider Name | GOODNESS EBUZIEM NP, APRN, RN
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Gender | Female
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 213 N MORGAN ST UNIT 1D
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City | CHICAGO
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State | IL
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Zip | 60607-1721
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Country | US
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Telephone | 773-707-8641
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Fax |
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Provider Business Mailing Address
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Address Line | 10338 S FOREST AVE
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City | CHICAGO
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State | IL
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Zip | 60628-2817
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Country | US
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Telephone | 773-707-8641
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209026923
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License Number State | IL
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