Provider Demographics
NPI:1306292990
Name:OBIEKWE, CHIGOZIRIM (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CHIGOZIRIM
Middle Name:
Last Name:OBIEKWE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11730 S MARSHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4904
Mailing Address - Country:US
Mailing Address - Phone:773-568-8370
Mailing Address - Fax:773-568-8656
Practice Address - Street 1:11730 S MARSHFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4904
Practice Address - Country:US
Practice Address - Phone:773-568-8370
Practice Address - Fax:773-568-8656
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL051.296154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist