Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | IL | |
Y | 111NI0013X | Independent Medical Examiner | IL | |
N | 111NN0400X | Neurology | IL | |
N | 111NR0400X | Rehabilitation Chiropractor | IL |
NPI | 1720288566 |
---|---|
Provider Name | Dr. Irene Janis Ekpenyong |
First Address | Chicago, IL 60615-2846 |
Second Address | Chicago, IL 60620-1641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 19/07/2007 |