Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036132446 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036132446 | IL |
NPI | 1386962389 |
---|---|
Provider Name | Dr. Ike Stanley Okwuosa |
First Address | Chicago, IL 60616 |
Second Address | Chicago, IL 60611-2981 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 13/08/2019 |