Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD.38283 | AL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD.38283 | AL |
NPI | 1124424817 |
---|---|
Provider Name | Dr. Chibuzo Churchill Ilonze |
First Address | Birmingham, AL 35233-1711 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2014 |
Last Update Date | 18/08/2021 |