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NPI Code Detail

MEDICARE: NDIDI OKANU NP-C

MEDICARE: NDIDI OKANU NP-C
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
1363L00000XNurse Practitioner209011407IL
2363L00000XNurse PractitionerR254241MD
3363L00000XNurse PractitionerNP50000385DC

General Provider Information

NPI Number : 1740600311
Entity Type Code : Individual
Provider Name (Legal Business Name) : NDIDI OKANU NP-C
Provider Business Mailing Address
First Line : 213 N RACINE AVE
Second Line : SUITE 100
City : CHICAGO
State : IL
Zip : 60607-1644
Country : US
Telephone Number : 312-733-9730
Fax Number : 773-866-8014
Provider Business Practice Location Address
First Line : 3348 W 87TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-3767
Country : US
Telephone Number : 773-776-4471
Fax Number : 773-564-3510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2014
Last Update Date : 09/01/2022

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Directions to “ NDIDI OKANU NP-C” Practice Location

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