Provider Demographics
NPI:1942779152
Name:UTTI, CHUKWUELOKA ANTHONY (PTA)
Entity Type:Individual
Prefix:
First Name:CHUKWUELOKA
Middle Name:ANTHONY
Last Name:UTTI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17307 LATHROP AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:EAST HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2605
Mailing Address - Country:US
Mailing Address - Phone:646-270-0158
Mailing Address - Fax:
Practice Address - Street 1:2425 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2612
Practice Address - Country:US
Practice Address - Phone:773-721-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant