Individual
CHISALU T NCHEKWUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18127 WILLIAM ST, LANSING, IL 60438-3921
(708) 889-6621
(708) 889-6675
Mailing address
4140 SOUTHWEST HWY, HOMETOWN, IL 60456-1135
(708) 422-5700
(708) 422-9535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-149564
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036149564
—
IL
01
—
PENDING
MEDICARE
IL
Enumeration date
04/03/2014
Last updated
06/12/2019
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