Individual
EPHRAIM MBACHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1324 W CORNELIA AVE APT 1, CHICAGO, IL 60657-8159
(219) 588-4364
Mailing address
1324 W CORNELIA AVE APT 1, CHICAGO, IL 60657-8159
(219) 588-4364
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2024
Last updated
04/20/2024
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