MEDICARE: EMMANUEL CHINONSO CHIGBU

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	172A00000X	Driver		IN
2	171M00000X	Case Manager/Care Coordinator		IN
3	374U00000X	Home Health Aide	25-019829-1	IN

General Provider Information

NPI Number	:	1285458059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL CHINONSO CHIGBU

Provider Business Mailing Address
First Line	:	7446 AMITY DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2973
Country	:	US
Telephone Number	:	317-363-8848
Fax Number	:

Provider Business Practice Location Address
First Line	:	7446 AMITY DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2973
Country	:	US
Telephone Number	:	463-304-2403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2024
Last Update Date	:	12/10/2025

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