Healthcare Provider Details

I. General information

NPI: 1639826035
Provider Name (Legal Business Name): ANUOLUWAPO MEFFUL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2022
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N EOLA RD STE 110
AURORA IL
60502-9619
US

IV. Provider business mailing address

444 N EOLA RD STE 110
AURORA IL
60502-9619
US

V. Phone/Fax

Practice location:
  • Phone: 630-692-5660
  • Fax: 630-692-5661
Mailing address:
  • Phone: 630-926-5660
  • Fax: 630-692-5661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209024787
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: