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General NPI Number Information
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NPI Number | 1275049694
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Entity Type | Individual
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Provider Name | ISOKEN FRANCA OGBOMO FNP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 1522 SCHAFER AVE
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City | BOLINGBROOK
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State | IL
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Zip | 60490-3230
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Country | US
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Telephone | 312-451-6418
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Fax |
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Provider Business Mailing Address
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Address Line | 402 W BOUGHTON RD STE A
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1998
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Country | US
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Telephone | 312-451-6418
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209017025
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License Number State | IL
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