Doctor Name: | JULIUS CHUCKS AJIDE |
NPI Number: | 1487989083 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNA |
License Number: | |
Business Practice Address: | 1770 1st St Suite 703 Highland Park, IL - 600353200 |
Business Phone Number: | 8474331539 |
Business Fax Number: | |
Mailing Address: | 161 Providence Dr, MATTESON |
State: | IL |
Postal Code: | 604431396 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/15/2009 |
NPI Last Update Date: | 10/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |