Provider Demographics
NPI:1992558746
Name:NWANKWO, IJEOMA OLUCHI (MBBS)
Entity type:Individual
Prefix:DR
First Name:IJEOMA
Middle Name:OLUCHI
Last Name:NWANKWO
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WIGWAM HOLLOW RD APT 1003
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:IL
Mailing Address - Zip Code:61455-7642
Mailing Address - Country:US
Mailing Address - Phone:815-766-1132
Mailing Address - Fax:
Practice Address - Street 1:701 W 5TH ST # TX
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79763-4206
Practice Address - Country:US
Practice Address - Phone:432-703-5375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program