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General NPI Number Information
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NPI Number | 1508329707
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Entity Type | Individual
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Provider Name | MR. OLUWAMAYOWA JOHN OGINNI
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Gender | Male
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Dates
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Enumeration Date | 04/13/2019
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Last Update Date | 04/13/2019
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Provider Practice Location Address
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Address Line | 2000 W ARTHUR AVE
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City | CHICAGO
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State | IL
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Zip | 60645-5544
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Country | US
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Telephone | 773-654-3206
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Fax |
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Provider Business Mailing Address
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Address Line | 47 W POLK ST STE 100249
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City | CHICAGO
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State | IL
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Zip | 60605-2000
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Country | US
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Telephone | 773-751-9426
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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