Healthcare Provider Details

I. General information

NPI: 1437048451
Provider Name (Legal Business Name): ABIOLA ELUSOJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 N HIGHLAND AVE
AURORA IL
60506-1401
US

IV. Provider business mailing address

148 E LARK AVE
CORTLAND IL
60112-4034
US

V. Phone/Fax

Practice location:
  • Phone: 630-966-4000
  • Fax:
Mailing address:
  • Phone: 312-459-9076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041.524976
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: