Individual
EBUKA EDWIN ODUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 OLD JACKSONVILLE RD STE D, SPRINGFIELD, IL 62704-7441
(217) 544-9252
(217) 529-4154
Mailing address
2901 OLD JACKSONVILLE RD STE D, SPRINGFIELD, IL 62704-7441
(217) 544-9252
(217) 529-4154
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036173913
IL
207R00000X
Internal Medicine Physician
125.076620
IL
2084P0800X
Psychiatry Physician
Primary
036173913
IL
2084P0800X
Psychiatry Physician
125.076620
IL
Other
Enumeration date
06/05/2020
Last updated
10/27/2025
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