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General NPI Number Information
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NPI Number | 1033987979
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Entity Type | Individual
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Provider Name | TOBI SAMUEL ADEBOYEJO PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 1632 W COLONIAL PKWY
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City | INVERNESS
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State | IL
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Zip | 60067-4725
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Country | US
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Telephone | 331-275-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 1632 W COLONIAL PKWY
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City | INVERNESS
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State | IL
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Zip | 60067-4725
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Country | US
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Telephone | 847-510-7046
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Fax | 847-631-3760
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209035234
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License Number State | IL
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