Provider Demographics
NPI:1073754586
Name:ANNE & TOCHUKWU ONYEKWULUJE MD PC
Entity Type:Organization
Organization Name:ANNE & TOCHUKWU ONYEKWULUJE MD PC
Other - Org Name:ANNE ONYEKWULUJE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONYEKWULUJE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-728-2487
Mailing Address - Street 1:PO BOX 5111
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-5111
Mailing Address - Country:US
Mailing Address - Phone:630-728-2487
Mailing Address - Fax:
Practice Address - Street 1:3724 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-3820
Practice Address - Country:US
Practice Address - Phone:773-486-3300
Practice Address - Fax:773-252-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093890Medicaid
ILG58904Medicare UPIN
IL036093890Medicaid