Provider Demographics
NPI:1710446885
Name:CROMWELL, EUNICE OTUWA (DNP, APRN)
Entity type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:OTUWA
Last Name:CROMWELL
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6423 N DAMEN AVE APT 2E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5620
Mailing Address - Country:US
Mailing Address - Phone:773-526-9493
Mailing Address - Fax:
Practice Address - Street 1:779 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3509
Practice Address - Country:US
Practice Address - Phone:312-382-8308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.019022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily