Provider Demographics
NPI:1811299308
Name:ONYEZIA, NNEKA ESTELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:NNEKA
Middle Name:ESTELLE
Last Name:ONYEZIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:NNEKA
Other - Middle Name:ESTELLE ONYEZIA
Other - Last Name:COBHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:659 W RANDOLPH ST APT 1020
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2246
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 303
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:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008034103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical