Provider Demographics
NPI:1043927874
Name:OKOLIE, ADANNA (FNP)
Entity Type:Individual
Prefix:
First Name:ADANNA
Middle Name:
Last Name:OKOLIE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 DOXBURY LN
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3454
Mailing Address - Country:US
Mailing Address - Phone:708-271-3537
Mailing Address - Fax:
Practice Address - Street 1:475 DOXBURY LN
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-3454
Practice Address - Country:US
Practice Address - Phone:708-271-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL029026273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily