Provider Demographics
NPI:1275119562
Name:NATOBE LLC
Entity Type:Organization
Organization Name:NATOBE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHIEDZA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAKUDU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP
Authorized Official - Phone:312-970-0036
Mailing Address - Street 1:PO BOX 3335
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-3335
Mailing Address - Country:US
Mailing Address - Phone:312-970-0036
Mailing Address - Fax:949-561-4847
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5709
Practice Address - Country:US
Practice Address - Phone:312-970-0036
Practice Address - Fax:949-561-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277000271OtherIL APN LICENSE