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NPI Code Detail

MEDICARE: OLUBUKOLA O ABIODUN

MEDICARE: OLUBUKOLA O ABIODUN
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
1183500000XPharmacist051304763IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386372688
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLUBUKOLA O ABIODUN
Provider Business Mailing Address
First Line : 7530 S STONY ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60649-3914
Country : US
Telephone Number : 773-288-7000
Fax Number : 773-288-7009
Provider Business Practice Location Address
First Line : 7530 S STONY ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60649-3914
Country : US
Telephone Number : 773-288-7000
Fax Number : 773-288-7009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2022
Last Update Date : 08/13/2022

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Directions to “ OLUBUKOLA O ABIODUN ” Practice Location

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