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General NPI Number Information
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NPI Number | 1538960125
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Entity Type | Individual
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Provider Name | MORUFAT ISHOLA AJAYI PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 5851 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2394
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Country | US
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Telephone | 708-574-6143
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Fax |
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Provider Business Mailing Address
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Address Line | 20024 MOHAWK TRL
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1126
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Country | US
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Telephone | 708-574-6143
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209031629
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License Number State | IL
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