Individual provider · Type 1 NPI

Theodore Lord Agbemaple, MD

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1255190690 Active

Practice location

2900 N Lake Shore Dr
Chicago, IL 60657-5640

Call (773) 665-3000 Map

Mailing address

926 N Walnut St
Springfield, IL 62702-3747

Other practice locations

  • 711 W North Ave, Chicago, IL 60610-1174 · (213) 337-1982

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1255190690

Theodore Lord Agbemaple, MD's National Provider Identifier is 1255190690, issued on Mar 18, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on Mar 18, 2024.