| Doctor Name: | MRS. JOSEPHINE NWAWUEZE |
| NPI Number: | 1073944872 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 209.011001 |
| Business Practice Address: | 4428 Clonard Pl Matteson, IL - 604432989 |
| Business Phone Number: | 7082500469 |
| Business Fax Number: | |
| Mailing Address: | 1645 Cottage Grove Ave, FORD HEIGHTS |
| State: | IL |
| Postal Code: | 604113818 |
| Phone Number: | 7087535800 |
| Fax Number: | |
| NPI Enumeration Date: | 12/03/2013 |
| NPI Last Update Date: | 09/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209.011001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |