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NPI Code Detail

MEDICARE: CROSS ROAD OBSTETRICS AND GYNECOLOGY CLINIC

MEDICARE: CROSS ROAD OBSTETRICS AND GYNECOLOGY CLINIC
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
1174400000XSpecialist036094748IL

General Provider Information

NPI Number : 1053595918
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSS ROAD OBSTETRICS AND GYNECOLOGY CLINIC
Provider Business Mailing Address
First Line : P.O. BOX 5111
Second Line :
City : OAKBROOK
State : IL
Zip : 60522-5111
Country : US
Telephone Number : 773-486-3300
Fax Number : 773-486-3071
Provider Business Practice Location Address
First Line : 3724 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-3820
Country : US
Telephone Number : 773-486-3300
Fax Number : 773-486-3071
Authorized Official
Title or Position : PHYSICIAN
Name : DR. TOCHUKWU O ONYEKWULUJE
Credential : M.D.
Telephone Number : 773-486-3300
Provider Enumeration Date : 12/27/2007
Last Update Date : 01/03/2008

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Directions to “CROSS ROAD OBSTETRICS AND GYNECOLOGY CLINIC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.