Provider Demographics
NPI:1578213757
Name:WOSUEZI, CHIMENE (LPN)
Entity Type:Individual
Prefix:MR
First Name:CHIMENE
Middle Name:
Last Name:WOSUEZI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:MR
Other - First Name:CHIMENE
Other - Middle Name:
Other - Last Name:WOSUEZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FAWEZ HELPING HANDS
Mailing Address - Street 1:7516 N DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2501
Mailing Address - Country:US
Mailing Address - Phone:312-613-7559
Mailing Address - Fax:773-961-8337
Practice Address - Street 1:7516 N DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2501
Practice Address - Country:US
Practice Address - Phone:312-613-7559
Practice Address - Fax:773-961-8337
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043116109164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse