Provider Demographics
NPI:1689843021
Name:CHUKWUKELU, CHRIS E
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:E
Last Name:CHUKWUKELU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 CLEAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-9247
Mailing Address - Country:US
Mailing Address - Phone:214-779-1110
Mailing Address - Fax:
Practice Address - Street 1:2860 CLEAR CREEK DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-9247
Practice Address - Country:US
Practice Address - Phone:214-779-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health