Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MT211917 | PA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 125.077272 | IL |
NPI | 1376993162 |
---|---|
Provider Name | Dr. Chijindu Emenari |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Chicago, IL 60637-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 31/05/2021 |