Individual
CHINEZE EKILISIE MBANUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-1601
Mailing address
600 S PAULINA ST, CHICAGO, IL 60612-3806
(313) 942-7100
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
5315233823
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/25/2026
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