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General NPI Number Information
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NPI Number | 1245359025
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Entity Type | Individual
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Provider Name | TUNJI LADIPO MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 45 W 111TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-4200
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Country | US
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Telephone | 773-995-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 45 W 111TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-4200
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Country | US
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Telephone | 773-995-3195
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Fax | 773-681-7113
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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 | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 36-056157
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 036-056167
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-056167
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036-056167
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License Number State | IL
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