Provider Demographics
NPI:1336704089
Name:UZOMA, NKECHINYERE (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:NKECHINYERE
Middle Name:
Last Name:UZOMA
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 CULLODEN ST
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-4318
Mailing Address - Country:US
Mailing Address - Phone:708-228-0832
Mailing Address - Fax:
Practice Address - Street 1:3709 CULLODEN ST
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-4318
Practice Address - Country:US
Practice Address - Phone:312-864-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.291592163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management