Provider Demographics
NPI:1740599448
Name:OFOMA, IHUOMA CHINWE (MD)
Entity Type:Individual
Prefix:DR
First Name:IHUOMA
Middle Name:CHINWE
Last Name:OFOMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IHUOMA
Other - Middle Name:CHINWE
Other - Last Name:OFOMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9127 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-2709
Mailing Address - Country:US
Mailing Address - Phone:773-779-5951
Mailing Address - Fax:773-779-8711
Practice Address - Street 1:1901 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-1903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.121991207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology