MEDICARE: DOCTORS UNLIMITED SERVICE CORPORATION

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
1	207R00000X	Internal Medicine Physician	036118945	IL

General Provider Information

NPI Number	:	1265739643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS UNLIMITED SERVICE CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 806112
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60680-4122
Country	:	US
Telephone Number	:	773-933-9300
Fax Number	:	773-933-9302

Provider Business Practice Location Address
First Line	:	1750 E 87TH ST
Second Line	:	SUITE 109
City	:	CHICAGO
State	:	IL
Zip	:	60617-2713
Country	:	US
Telephone Number	:	773-933-9300
Fax Number	:	773-933-9302

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. OTUONYE EZERIBE ONYEWUCHI
Credential	:	MD, MPH
Telephone Number	:	773-933-9300

Provider Enumeration Date	:	02/19/2011
Last Update Date	:	11/10/2020

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Directions to “DOCTORS UNLIMITED SERVICE CORPORATION ” Practice Location

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