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Individual

IFEYINWA ILECHUKWU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10350 W 9 MILE RD, OAK PARK, MI 48237-2913
(248) 541-6630
(248) 541-6631
Mailing address
10350 W 9 MILE RD, OAK PARK, MI 48237-2913
(248) 541-6630
(248) 541-6631

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301072967
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000013644
CAPE
01
250823437
BLUE CROSS OF MI
MI
01
373880
AETNA
05
4695533
MI
01
5594424
FIRST HEALTH NETWORK
01
7900526
AETNA HMO
Enumeration date
08/25/2006
Last updated
07/02/2015
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