Individual
ADAEZE ILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 N CENTRAL AVE, PHOENIX, AZ 85004-2322
(951) 545-1482
Mailing address
4053 KYNDRA CIR, RICHARDSON, TX 75082-2762
(951) 545-1482
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1075587
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
287006
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
287006
NURSING LICENSE
AZ
Enumeration date
10/30/2014
Last updated
09/26/2025
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