Individual
DR. RICHARD A EGWELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9135 S EXCHANGE AVE, CHICAGO, IL 60617-4225
(773) 374-2441
(773) 374-7652
Mailing address
PO BOX 17578, CHICAGO, IL 60617-0578
(773) 374-2441
(773) 374-7652
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207Q00000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051741
—
IL
01
—
21607598
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/23/2007
Last updated
12/08/2011
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