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General NPI Number Information
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NPI Number | 1093689309
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Entity Type | Organization
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Legal Business Name | REJUVENATE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 3515 SUMAC DR
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City | JOLIET
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State | IL
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Zip | 60435-9019
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Country | US
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Telephone | 815-514-6887
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 SUMAC DR
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City | JOLIET
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State | IL
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Zip | 60435-9019
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Country | US
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Telephone | 815-514-6887
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLUDAYO OJELADE
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Credential | NP
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Telephone | 773-425-4345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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