MEDICARE: ADEKUNLE ADENIJI

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	163WH0200X	Home Health Registered Nurse	041400848	IL
2	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1386193464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEKUNLE ADENIJI

Provider Business Mailing Address
First Line	:	525 E 46TH PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-4205
Country	:	US
Telephone Number	:	773-507-8609
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 E 46TH PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-4205
Country	:	US
Telephone Number	:	773-507-8609
Fax Number	:

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

Provider Enumeration Date	:	09/29/2016
Last Update Date	:	09/29/2016

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Directions to “ ADEKUNLE ADENIJI ” Practice Location

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