Provider Demographics
NPI:1265739643
Name:DOCTORS UNLIMITED SERVICE CORPORATION
Entity type:Organization
Organization Name:DOCTORS UNLIMITED SERVICE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OTUONYE
Authorized Official - Middle Name:EZERIBE
Authorized Official - Last Name:ONYEWUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:773-933-9300
Mailing Address - Street 1:PO BOX 806112
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-4122
Mailing Address - Country:US
Mailing Address - Phone:773-933-9300
Mailing Address - Fax:773-933-9302
Practice Address - Street 1:1750 E 87TH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2713
Practice Address - Country:US
Practice Address - Phone:773-933-9300
Practice Address - Fax:773-933-9302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-19
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty