Basic Information
Provider Information
NPI: 1467890145
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKOH
FirstName: CRAIG
MiddleName: CHIKE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2111 OGDEN AVE
Address2:  
City: AURORA
State: IL
PostalCode: 605047597
CountryCode: US
TelephoneNumber: 6309783800
FaxNumber: 6308623085
Practice Location
Address1: 2111 OGDEN AVE
Address2:  
City: AURORA
State: IL
PostalCode: 605047597
CountryCode: US
TelephoneNumber: 6309783800
FaxNumber: 6308623085
Other Information
ProviderEnumerationDate: 06/04/2013
LastUpdateDate: 06/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X036152796ILY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0005X69319WIN Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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