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Individual

CONNIE C ONYEKACHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PROVIDER

Contact information

Practice address
1247 N COUNTY RD, MASCOUTAH, IL 62258-2713
(832) 600-2117
Mailing address
1247 N COUNTY RD, MASCOUTAH, IL 62258-2713
(832) 600-2117

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
041495849
IL
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
041495849
IL
171W00000X
Contractor
TX

Other

Enumeration date
02/25/2012
Last updated
09/22/2022
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