Physician Compare National (NPI:1043596547)

HEALTHCARE PROVIDER: CHIEDZA NWAKUDU NURSE PRACTITIONER

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1043596547
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052586278
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111215000749
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NWAKUDU
	Individual professional last name
Provider First Name	CHIEDZA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TAPESTRY TELEHEALTH PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4789942335
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1 HAMILTON LN
	Group Practice or individual's line 1 address
City	OAK BROOK
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	605231762
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2036668145
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	160057
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREAT RIVER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	161300
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAUM HARMON MERCY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y