Organization
BOYCIN MEDICAL CLINIC LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NDUDI C ANIEMEKA MD (PROPERITOR)
(773) 378-4823
Entity
Organization
Contact information
Practice address
5219 W MADISON ST, 1ST FLOOR, CHICAGO, IL 60644-4152
(773) 378-4823
(773) 378-9401
Mailing address
5219 W MADISON ST, CHICAGO, IL 60644-4152
(773) 378-4823
(773) 378-9401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036126142
IL
207R00000X
Internal Medicine Physician
Primary
036085291
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085291
—
IL
Enumeration date
02/08/2010
Last updated
05/04/2011
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