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General NPI Number Information
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NPI Number | 1437164258
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Entity Type | Individual
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Provider Name | IFENLOTA O OJIAKO M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 1441 BRANDING AVE STE 310
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5624
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Country | US
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Telephone | 630-829-1084
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 036-106003
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1650
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License Number State | WI
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