Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Russell Edafetanure-Ibeh

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1568291268

Russell Edafetanure-Ibeh is a Student in an Organized Health Care Education/Training Program in Chicago, Illinois. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1853 W Polk St
Chicago, IL 60612-4355
Phone: (312) 996-5636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1568291268
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 31, 2024
Last updated in NPPESJuly 31, 2024
Certification dateJuly 30, 2024

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