Provider Demographics
NPI:1760238927
Name:CHUKWUNENYE, CHINAZO CHIDI (MD)
Entity type:Individual
Prefix:
First Name:CHINAZO
Middle Name:CHIDI
Last Name:CHUKWUNENYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 W. 95TH STREET - ADULT MEDICINE CENTER
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OAK LAWRY
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:708-398-0287
Mailing Address - Fax:
Practice Address - Street 1:4220 W. 95TH STREET - ADULT MEDICINE CENTER
Practice Address - Street 2:SUITE 200
Practice Address - City:OAK LAWRY
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:708-398-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program