Organization
DR. ELOM AMUZU LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELOM AMUZU PHD (OWNER AND LICENSED PSYCHOLOGIST)
(312) 292-9753
Entity
Organization
Contact information
Practice address
18237 KEDZIE AVE, HOMEWOOD, IL 60430-1411
(708) 299-0035
Mailing address
18237 KEDZIE AVE, HOMEWOOD, IL 60430-1411
(312) 292-9753
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071010304
PROFESSIONAL LICENSE NO
IL
Enumeration date
09/03/2020
Last updated
11/08/2020
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