Provider Demographics
NPI:1043870249
Name:CHUKWU, NEVILLE WUSAOBI (PHARM D)
Entity Type:Individual
Prefix:
First Name:NEVILLE
Middle Name:WUSAOBI
Last Name:CHUKWU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 ONTARIO ST APT 501
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1943
Mailing Address - Country:US
Mailing Address - Phone:630-670-0028
Mailing Address - Fax:
Practice Address - Street 1:8361 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1001
Practice Address - Country:US
Practice Address - Phone:708-452-8062
Practice Address - Fax:708-452-4975
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist