Provider Demographics
NPI:1467349043
Name:IC HEALTH SERVICES INC
Entity type:Organization
Organization Name:IC HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIDINMA
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:ONYEGWU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,PMHNP
Authorized Official - Phone:301-793-0626
Mailing Address - Street 1:8000 JUMPERS HOLE RD STE 223
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1036
Mailing Address - Country:US
Mailing Address - Phone:301-793-0626
Mailing Address - Fax:
Practice Address - Street 1:8000 JUMPERS HOLE RD STE 223
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1036
Practice Address - Country:US
Practice Address - Phone:443-620-3616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty