Provider Demographics
NPI:1629638325
Name:UDOKWU, CHINENYE ONYEKACHI (MD)
Entity type:Individual
Prefix:DR
First Name:CHINENYE
Middle Name:ONYEKACHI
Last Name:UDOKWU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-7775
Mailing Address - Fax:314-996-3087
Practice Address - Street 1:10 BARNES WEST DR
Practice Address - Street 2:DIV IM BONE AND MINERAL, STE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6287
Practice Address - Country:US
Practice Address - Phone:314-454-7775
Practice Address - Fax:314-996-3087
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024028795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200105979Medicaid