Provider Demographics
NPI:1902598105
Name:MADUIKE, CLARET UGONNA (NP)
Entity Type:Individual
Prefix:
First Name:CLARET
Middle Name:UGONNA
Last Name:MADUIKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 CARMEL DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-8483
Mailing Address - Country:US
Mailing Address - Phone:815-375-8000
Mailing Address - Fax:
Practice Address - Street 1:6208 CARMEL DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-8483
Practice Address - Country:US
Practice Address - Phone:815-375-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209027163363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health