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Individual

EBERECHUKWU O IBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1701 W MONTEREY AVE, CHICAGO, IL 60643-4257
(773) 445-0292
Mailing address
707 N WALNUT LN, SCHAUMBURG, IL 60194-2638
(708) 606-7219

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0036107391
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036107391
IL
05
036107391-5
IL
Enumeration date
05/04/2006
Last updated
04/19/2010
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