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General NPI Number Information
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NPI Number | 1114513462
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Entity Type | Individual
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Provider Name | KAYODE AKINWANDE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 12/20/2020
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Provider Practice Location Address
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Address Line | 8712 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60617-2708
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Country | US
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Telephone | 773-933-9200
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Fax | 773-933-9206
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Provider Business Mailing Address
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Address Line | 1220 S FEDERAL ST UNIT A
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City | CHICAGO
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State | IL
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Zip | 60605-3385
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Country | US
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Telephone | 708-280-4569
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051038238
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License Number State | IL
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