MEDICARE: TITILAYO ADELEKAN

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	363LF0000X	Family Nurse Practitioner	11025095	FL
2	363LF0000X	Family Nurse Practitioner	209025322	IL

General Provider Information

NPI Number	:	1760114342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TITILAYO ADELEKAN

Provider Business Mailing Address
First Line	:	1138 EMERALD AVE
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-2714
Country	:	US
Telephone Number	:	708-673-9850
Fax Number	:

Provider Business Practice Location Address
First Line	:	28945 STATE ROAD 54 STE 101
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-3218
Country	:	US
Telephone Number	:	630-755-0065
Fax Number	:

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

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	03/25/2024

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Directions to “ TITILAYO ADELEKAN ” Practice Location

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