Provider Demographics
NPI:1790161305
Name:NNEKA E. ONYEZIA PHD, LLC
Entity Type:Organization
Organization Name:NNEKA E. ONYEZIA PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NNEKA
Authorized Official - Middle Name:ESTELLE
Authorized Official - Last Name:ONYEZIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-725-0225
Mailing Address - Street 1:659 W RANDOLPH ST
Mailing Address - Street 2:APT 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2151
Mailing Address - Country:US
Mailing Address - Phone:312-725-0225
Mailing Address - Fax:
Practice Address - Street 1:1030 N CLARK ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-5467
Practice Address - Country:US
Practice Address - Phone:312-725-0225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008034103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty