MEDICARE: FOLARIN O ODUEYUNGBO APRN, CRNA

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	367500000X	Certified Registered Nurse Anesthetist	209005908	IL
2	367500000X	Certified Registered Nurse Anesthetist	3737	WI

General Provider Information

NPI Number	:	1932157294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FOLARIN O ODUEYUNGBO APRN, CRNA

Provider Business Mailing Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-933-6675
Fax Number	:	630-933-2614

Provider Business Practice Location Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-933-6675
Fax Number	:	630-933-2614

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	12/15/2025

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