Provider Demographics
NPI:1164182150
Name:OSHOKOYA, OMOLARA AMINAT (APRN)
Entity Type:Individual
Prefix:
First Name:OMOLARA
Middle Name:AMINAT
Last Name:OSHOKOYA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:OMOLARA
Other - Middle Name:AMINAT
Other - Last Name:OSHOKOYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:303 E WACKER DR STE 2102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5314
Mailing Address - Country:US
Mailing Address - Phone:708-785-7475
Mailing Address - Fax:
Practice Address - Street 1:20 BRIARCLIFF LN
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1665
Practice Address - Country:US
Practice Address - Phone:708-785-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-18
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209024525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily