Provider Demographics
NPI:1740791607
Name:ILO, EMMANUEL OBINNA
Entity Type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:OBINNA
Last Name:ILO
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 1:611 EDGEWOOD ST NE APT 1125
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-4206
Mailing Address - Country:US
Mailing Address - Phone:202-813-5768
Mailing Address - Fax:
Practice Address - Street 1:611 EDGEWOOD ST NE APT 1125
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-4206
Practice Address - Country:US
Practice Address - Phone:202-813-5768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide