Provider Demographics
NPI:1245775147
Name:ORJI, JULIET MARY (NP)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:MARY
Last Name:ORJI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3344 W PETERSON AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3531
Mailing Address - Country:US
Mailing Address - Phone:708-423-4710
Mailing Address - Fax:
Practice Address - Street 1:8624 LAPORTE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2823
Practice Address - Country:US
Practice Address - Phone:773-245-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-31
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041264371163W00000X
IL209015405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse