Provider Demographics
NPI:1578855219
Name:ONYENSO, CHERECHI V (FNP)
Entity Type:Individual
Prefix:
First Name:CHERECHI
Middle Name:V
Last Name:ONYENSO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1473 RING RING ROAD
Mailing Address - Street 2:GREAT HEIGHTS FAMILY MEDICINE
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409
Mailing Address - Country:US
Mailing Address - Phone:708-743-3637
Mailing Address - Fax:779-423-6041
Practice Address - Street 1:1473 RING RING ROAD
Practice Address - Street 2:GREAT HEIGHTS FAMILY MEDICINE
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409
Practice Address - Country:US
Practice Address - Phone:708-743-3637
Practice Address - Fax:779-423-6041
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily