Provider Demographics
NPI:1164498812
Name:OYEDIJO, DOTUN (MD)
Entity Type:Individual
Prefix:
First Name:DOTUN
Middle Name:
Last Name:OYEDIJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30907
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90030-0907
Mailing Address - Country:US
Mailing Address - Phone:310-335-4057
Mailing Address - Fax:310-335-4098
Practice Address - Street 1:1600 W US ROUTE 6
Practice Address - Street 2:THE RADIATION THERAPY CENTER OF MORRIS HOSPITAL
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-8854
Practice Address - Country:US
Practice Address - Phone:815-364-8915
Practice Address - Fax:815-941-0743
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI448442085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H27278Medicare UPIN
050345300Medicare ID - Type Unspecified