Individual
DR. OLISA KINGSLEY EZEGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(708) 682-5977
Mailing address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1.25071705
IL
207R00000X
Internal Medicine Physician
125071705
IL
207RC0000X
Cardiovascular Disease Physician
Primary
334705
NY
Other
Enumeration date
07/05/2018
Last updated
05/22/2025
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