Individual
UZOMA OKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 S GREENLEAF ST, SUITE J, GURNEE, IL 60031-3398
(847) 672-6478
(847) 672-7432
Mailing address
PO BOX 6119, VERNON HILLS, IL 60061-6119
(847) 672-6478
(847) 672-7432
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-109992
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
036109992
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109992
—
IL
01
—
1366768772
HAWTHORN BEHAVIORAL HEALTH
IL
01
—
212793
MEDICARE NUMBER
IL
Enumeration date
07/20/2005
Last updated
05/10/2021
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