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NPI Code Detail

MEDICARE: CLARA AKHIGBE MD

MEDICARE: CLARA AKHIGBE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center036085642IL

General Provider Information

NPI Number : 1013285477
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARA AKHIGBE MD
Provider Business Mailing Address
First Line : 6202 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60621-2029
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6202 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60621-2029
Country : US
Telephone Number : 773-962-0633
Fax Number :
Authorized Official
Title or Position : PEDIATRICIAN
Name : DR. CLARA AKHIGBE
Credential :
Telephone Number : 773-994-0633
Provider Enumeration Date : 12/13/2011
Last Update Date : 12/13/2011

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