MEDICARE: DR. EMEM INYANG ADOLF-UBOKUDOM M.D.

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	207RR0500X	Rheumatology Physician	277137	MA
2	207R00000X	Internal Medicine Physician	125060419	IL

General Provider Information

NPI Number	:	1861780603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMEM INYANG ADOLF-UBOKUDOM M.D.

Provider Business Mailing Address
First Line	:	5 MIDDLESEX AVE
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02145-1102
Country	:	US
Telephone Number	:	773-542-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 SOUTH CALIFORNIA AVENUE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1797
Country	:	US
Telephone Number	:	773-542-2000
Fax Number	:

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

Provider Enumeration Date	:	07/14/2011
Last Update Date	:	11/05/2018

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