Ekechukwu, Kenneth U
Ekechukwu, Kenneth U is an sole proprietor health care provider with primary practice located at 1225 Harlem Ave , Forest Park IL 60130-2407. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Ekechukwu, Kenneth U can be contacted via phone (708) 657-4540.Contact Information
Primary practice address
1225 Harlem Ave
Forest Park IL 60130-2407
Phone: (708) 657-4540
Fax: (708) 657-4535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-083256 | Illinois |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036-083256 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 036-083256 | Illinois |
Profile Details
| NPI number | 1255331096 |
|---|---|
| LBN Legal business name | Ekechukwu, Kenneth U |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255331096 | NPPES |
| Illinois | MEDICAID | 036-083256-4 |
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