Organization
CHIKARE HEALTH SYSTEM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANAYO ODELUGA MD (MD/OWNER)
(219) 397-6000
Entity
Organization
Contact information
Practice address
915 W CHICAGO AVE, EAST CHICAGO, IN 46312-3308
(219) 397-6000
Mailing address
915 W CHICAGO AVE, EAST CHICAGO, IN 46312-3308
(219) 397-6000
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01047947A
—
IL
Enumeration date
04/26/2019
Last updated
01/09/2020
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