Individual
ENYINNAYA OMELOGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2525 S MICHIGAN AVE, CHICAGO, IL 60616-2315
(651) 300-2282
Mailing address
1301 W 22ND ST, SUITE 610, OAK BROOK, IL 60523-2006
(651) 300-2282
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041379731
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209014559
IL
Other
Enumeration date
07/09/2016
Last updated
11/21/2016
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