Organization
E.Z.FIAKPUI, M.D., M.S., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA GARZA R.N. (REGISTERED NURSE)
(773) 731-2700
Entity
Organization
Contact information
Practice address
2315 E 93RD ST STE 337, CHICAGO, IL 60617-3948
(773) 731-2700
(773) 731-8687
Mailing address
2315 E 93RD ST STE 337, CHICAGO, IL 60617-3948
(773) 731-2700
(773) 731-8687
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21603450
BLUECROSS/BLUESHIELD
IL
Enumeration date
03/28/2008
Last updated
07/21/2022
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