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General NPI Number Information
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NPI Number | 1699360289
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Entity Type | Individual
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Provider Name | OLAJUMOKE ELIZABETH ADEKOYA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 1406 E 68TH ST APT 3
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City | CHICAGO
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State | IL
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Zip | 60637-6235
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Country | US
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Telephone | 773-782-7609
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 E 68TH ST APT 3
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City | CHICAGO
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State | IL
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Zip | 60637-6235
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Country | US
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Telephone | 773-782-7609
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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 | 71011593A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209022776
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License Number State | IL
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