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NPI Code Detail

MEDICARE: NURUDEEN AFOLABI

MEDICARE:   NURUDEEN  AFOLABI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209020869IL

General Provider Information

NPI Number : 1568096147
Entity Type Code : Individual
Provider Name (Legal Business Name) : NURUDEEN AFOLABI
Provider Business Mailing Address
First Line : 4714 S EVANS AVE APT 1S
Second Line :
City : CHICAGO
State : IL
Zip : 60615-1656
Country : US
Telephone Number : 312-383-7925
Fax Number :
Provider Business Practice Location Address
First Line : 4714 S EVANS AVE APT 1S
Second Line :
City : CHICAGO
State : IL
Zip : 60615-1656
Country : US
Telephone Number : 312-383-7925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2020
Last Update Date : 02/24/2020

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Directions to “ NURUDEEN AFOLABI ” Practice Location

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