Provider Demographics
NPI:1376376848
Name:AI CANCER THERAPEUTIX SC
Entity type:Organization
Organization Name:AI CANCER THERAPEUTIX SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUKWUEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:UZOKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-870-3720
Mailing Address - Street 1:PO BOX 15250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4700 N MARINE DR STE 315
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7976
Practice Address - Country:US
Practice Address - Phone:872-201-8479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty