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General NPI Number Information
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NPI Number | 1417632407
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Entity Type | Individual
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Provider Name | CHRISTOPHER OJEMIEGA IRUOLAGBE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3333 GREEN BAY ROAD
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City | NORTH CHICAGO
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State | IL
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Zip | 60064
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Country | US
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Telephone | 847-578-3227
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 S WHITE OAK DR APT 1725
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City | WAUKEGAN
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State | IL
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Zip | 60085-8359
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Country | US
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Telephone | 312-687-9943
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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