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General NPI Number Information
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NPI Number | 1073388104
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Entity Type | Organization
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Legal Business Name | ADEWELL HOLISTIC HEALTH & MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1833 HICKS RD STE D
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-1247
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Country | US
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Telephone | 847-610-9400
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Fax | 847-572-2170
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Provider Business Mailing Address
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Address Line | 1833 HICKS RD STE D
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-1247
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Country | US
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Telephone | 847-610-9400
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Fax | 847-572-2170
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Authorized Official
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Title or Position | FNP-C, PMHNP-BC
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Name | DR. ADERONKE OSHIBAJO
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Credential | APN
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Telephone | 847-610-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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