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General NPI Number Information
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NPI Number | 1639743107
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Entity Type | Individual
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Provider Name | OLADUNNI F BOLADALE
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Gender | Female
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 494 W BOUGHTON RD STE 2B
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1881
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Country | US
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Telephone | 331-246-6564
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Fax | 630-358-6841
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Provider Business Mailing Address
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Address Line | 494 W BOUGHTON RD STE 2B
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1881
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Country | US
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Telephone | 331-246-6564
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Fax | 630-358-6841
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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 | 277003428
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License Number State | IL
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