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General NPI Number Information
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NPI Number | 1710511936
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Entity Type | Individual
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Provider Name | KEHINDE TOLANI OLAITAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 2172 BLACKBERRY DR STE 204
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City | GENEVA
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State | IL
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Zip | 60134-1106
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Country | US
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Telephone | 630-262-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 1469 FAIRWAY DR APT 204
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City | NAPERVILLE
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State | IL
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Zip | 60563-9138
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Country | US
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Telephone | 682-551-5739
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.020501
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License Number State | IL
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