Provider Demographics
NPI:1578141149
Name:OGBUJI, CHUKWUNONYE ONYEKA (MD, BSC)
Entity type:Individual
Prefix:DR
First Name:CHUKWUNONYE
Middle Name:ONYEKA
Last Name:OGBUJI
Suffix:
Gender:M
Credentials:MD, BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 E NORRIS DR
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-3681
Mailing Address - Country:US
Mailing Address - Phone:815-433-1010
Mailing Address - Fax:
Practice Address - Street 1:1614 E NORRIS DR
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-3681
Practice Address - Country:US
Practice Address - Phone:815-433-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036168429208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program