MEDICARE: DR. ADEOLA SOLARU OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	056013620	IL

General Provider Information

NPI Number	:	1063912129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADEOLA SOLARU OTR/L

Provider Business Mailing Address
First Line	:	2714 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3920
Country	:	US
Telephone Number	:	708-328-8593
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3920
Country	:	US
Telephone Number	:	708-328-8593
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2018
Last Update Date	:	02/18/2025

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