Provider Demographics
NPI:1366623126
Name:NWABUDIKE, SINCHIEZE (PA)
Entity Type:Individual
Prefix:
First Name:SINCHIEZE
Middle Name:
Last Name:NWABUDIKE
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8930 WAUKEGAN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2126
Mailing Address - Country:US
Mailing Address - Phone:847-324-3976
Mailing Address - Fax:847-929-1154
Practice Address - Street 1:9000 WAUKEGAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2127
Practice Address - Country:US
Practice Address - Phone:847-375-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2021-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085-002887363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant