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NPI Code Detail

MEDICARE: ISMAIL ADEBAYO OYEBODE APN

MEDICARE: ISMAIL ADEBAYO OYEBODE APN
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 Practitioner209.021681IL
22085R0202XDiagnostic Radiology Physician209.021681IL

General Provider Information

NPI Number : 1669079018
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISMAIL ADEBAYO OYEBODE APN
Provider Business Mailing Address
First Line : 595 LARKSPUR DR
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4809
Country : US
Telephone Number : 773-517-3183
Fax Number : 630-756-2769
Provider Business Practice Location Address
First Line : 11000 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-3909
Country : US
Telephone Number : 773-517-3183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2020
Last Update Date : 04/13/2026

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