Individual
MRS. UWAILA IYENGUNMWENA IREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3242 CUMBERLAND TRL, OLYMPIA FLDS, IL 60461-1118
(773) 814-5690
Mailing address
50 S B B KING BLVD STE 100, MEMPHIS, TN 38103-2626
(901) 436-1381
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
06200631
IL
Other
Enumeration date
06/23/2020
Last updated
06/01/2022
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