Individual
DR. CHIZITAM IBEZIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 W HARRISON ST STE 400, CHICAGO, IL 60612-4861
(877) 632-6637
(708) 409-5179
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
(877) 632-6637
(708) 409-5179
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01096132A
IN
207X00000X
Orthopaedic Surgery Physician
036174858
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
01096132A
IN
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
036174858
IL
Other
Enumeration date
04/24/2019
Last updated
07/09/2025
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