Provider Demographics
NPI:1982878385
Name:ILOEGBUNAM, EUCHARIA N
Entity Type:Individual
Prefix:
First Name:EUCHARIA
Middle Name:N
Last Name:ILOEGBUNAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E 87TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-2706
Mailing Address - Country:US
Mailing Address - Phone:772-221-4273
Mailing Address - Fax:772-221-4565
Practice Address - Street 1:1750 E 87TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2706
Practice Address - Country:US
Practice Address - Phone:772-221-4273
Practice Address - Fax:772-221-4565
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL98544227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered