Provider Demographics
NPI:1326304833
Name:OKONKWO, CHINWE A (DO)
Entity Type:Individual
Prefix:
First Name:CHINWE
Middle Name:A
Last Name:OKONKWO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W CENTRAL AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-2135
Mailing Address - Country:US
Mailing Address - Phone:316-320-0501
Mailing Address - Fax:316-321-0503
Practice Address - Street 1:700 W CENTRAL AVE STE 412
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2135
Practice Address - Country:US
Practice Address - Phone:316-320-0501
Practice Address - Fax:316-321-0503
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-39129207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology