Provider Demographics
NPI:1386193464
Name:ADENIJI, ADEKUNLE
Entity Type:Individual
Prefix:
First Name:ADEKUNLE
Middle Name:
Last Name:ADENIJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 46TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-4205
Mailing Address - Country:US
Mailing Address - Phone:773-507-8609
Mailing Address - Fax:
Practice Address - Street 1:525 E 46TH PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-4205
Practice Address - Country:US
Practice Address - Phone:773-507-8609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041400848163WH0200X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide