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General NPI Number Information
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NPI Number | 1760449938
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Entity Type | Individual
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Provider Name | ADEYEMI OLUDARE FATOKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 315 E MCKINLEY RD
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City | OTTAWA
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State | IL
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Zip | 61350-4805
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Country | US
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Telephone | 815-434-0228
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Fax | 815-434-0148
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Provider Business Mailing Address
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Address Line | 1473 RING RD
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City | CALUMET CITY
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State | IL
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Zip | 60409-5459
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Country | US
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Telephone | 708-862-8156
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Fax | 708-862-8105
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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 | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 01062968A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 60259-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 64981
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 036084729
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 60259-20
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License Number State | WI
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