Provider Demographics
NPI:1073798617
Name:KOLAWOLE, OLATOKUNBO OLUWATOYIN (MD)
Entity Type:Individual
Prefix:DR
First Name:OLATOKUNBO
Middle Name:OLUWATOYIN
Last Name:KOLAWOLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:18201 S. LAGRANGE ROAD
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487
Mailing Address - Country:US
Mailing Address - Phone:708-479-6636
Mailing Address - Fax:708-479-9460
Practice Address - Street 1:18210 LA GRANGE RD
Practice Address - Street 2:200
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7722
Practice Address - Country:US
Practice Address - Phone:708-479-6636
Practice Address - Fax:708-479-9460
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036135113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine