Provider Demographics
NPI:1619770369
Name:NGENE, MUNACHISO AMANDA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MUNACHISO
Middle Name:AMANDA
Last Name:NGENE
Suffix:
Gender:
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:MUNACHISO
Other - Last Name:NGENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:4220 W 95TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2793
Mailing Address - Country:US
Mailing Address - Phone:312-949-4200
Mailing Address - Fax:708-423-1899
Practice Address - Street 1:4220 W 95TH ST STE 210
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2793
Practice Address - Country:US
Practice Address - Phone:312-949-4200
Practice Address - Fax:708-423-1899
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program