Healthcare Provider Details

I. General information

NPI: 1295653343
Provider Name (Legal Business Name): ECHELON HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 LARKSPUR DR
BOLINGBROOK IL
60440-4809
US

IV. Provider business mailing address

595 LARKSPUR DR
BOLINGBROOK IL
60440-4809
US

V. Phone/Fax

Practice location:
  • Phone: 240-574-0009
  • Fax: 240-368-1235
Mailing address:
  • Phone: 240-574-0009
  • Fax: 240-368-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ISMAIL A OYEBODE
Title or Position: SOLE PROPERITOR
Credential: FPA APN
Phone: 773-517-3183