Individual
OBINNA CHARLES ILUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
24 JOLIET ST, DYER, IN 46311-1705
(917) 922-9498
Mailing address
24 JOLIET ST, DYER, IN 46311-1705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28228006A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
139085
IN
367500000X
Certified Registered Nurse Anesthetist
RN328399
GA
Other
Enumeration date
06/19/2022
Last updated
05/20/2024
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