MEDICARE: ADEYINKA ADEBAYO

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	251J00000X	Nursing Care Agency
2	332BN1400X	Nursing Facility Supplies (DME)
3	363LF0000X	Family Nurse Practitioner	209018630	IL
4	363LF0000X	Family Nurse Practitioner	6669	MN
5	363LF0000X	Family Nurse Practitioner	AP139995	TX

General Provider Information

NPI Number	:	1952715294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEYINKA ADEBAYO

Provider Business Mailing Address
First Line	:	704 WOODEWIND DR
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-3972
Country	:	US
Telephone Number	:	630-544-4488
Fax Number	:

Provider Business Practice Location Address
First Line	:	3651 E BASELINE RD STE 230
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-5450
Country	:	US
Telephone Number	:	602-838-4049
Fax Number	:	310-496-0818

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

Provider Enumeration Date	:	06/15/2014
Last Update Date	:	06/06/2025

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