Provider Demographics
NPI:1790004620
Name:IGBOKWE, MELITA NONYEREM (MD)
Entity Type:Individual
Prefix:
First Name:MELITA
Middle Name:NONYEREM
Last Name:IGBOKWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PFINGSTEN RD STE 3001A
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1301
Mailing Address - Country:US
Mailing Address - Phone:847-657-5840
Mailing Address - Fax:847-657-5732
Practice Address - Street 1:2100 PFINGSTEN RD STE 3001A
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1301
Practice Address - Country:US
Practice Address - Phone:847-657-5840
Practice Address - Fax:847-657-5732
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132284207RC0200X, 207RP1001X, 208M00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist