Provider Demographics
NPI:1447232392
Name:KUTEYI, MOROUNKEJI E (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MOROUNKEJI
Middle Name:E
Last Name:KUTEYI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:MOROUNKEJI
Other - Middle Name:E
Other - Last Name:AKIN-OLUGBEMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15 SHEFFIELD LN
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2353
Mailing Address - Country:US
Mailing Address - Phone:847-207-1121
Mailing Address - Fax:
Practice Address - Street 1:2525 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1708
Practice Address - Country:US
Practice Address - Phone:847-207-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096730208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI29194Medicare UPIN
ILK17395Medicare PIN