Provider Demographics
NPI:1154672160
Name:EJECHI, ONUWA JULIET I
Entity Type:Individual
Prefix:MRS
First Name:ONUWA
Middle Name:JULIET
Last Name:EJECHI
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 EXCHANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-3307
Mailing Address - Country:US
Mailing Address - Phone:708-868-1287
Mailing Address - Fax:
Practice Address - Street 1:519 EXCHANGE AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-3307
Practice Address - Country:US
Practice Address - Phone:708-868-1287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057003496172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker