Provider Demographics
NPI:1215726401
Name:ESIAKA, CYNTHIA IFEOMA
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:IFEOMA
Last Name:ESIAKA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8807 N OZANAM AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1709
Mailing Address - Country:US
Mailing Address - Phone:773-943-1631
Mailing Address - Fax:
Practice Address - Street 1:8807 N OZANAM AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1709
Practice Address - Country:US
Practice Address - Phone:773-943-1631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209031637363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health