IndividualActive
Gabriel Ifejiasi
NPI 1962209759 · Home Health Registered Nurse · Lynwood, IL
Provider details
- NPI number
- 1962209759
- Entity type
- Individual
- Primary specialty
- Home Health Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 041487014 (IL)
Specialties & taxonomies
Nursing Service Providers
Practice location
20067 Marlin Ct
Lynwood, IL 60411-6903
Phone: (708) 308-1702
Approximate (ZIP-level) locationGet directions
Mailing address
20067 Marlin Ct
Lynwood, IL 60411-6903
Registry dates
- Enumerated
- 2025-02-27
- Last updated
- 2025-02-27
- Certified
- 2025-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.