Provider Demographics
NPI:1710511936
Name:OLAITAN, KEHINDE TOLANI (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KEHINDE
Middle Name:TOLANI
Last Name:OLAITAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 FAIRWAY DR APT 204
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9138
Mailing Address - Country:US
Mailing Address - Phone:682-551-5739
Mailing Address - Fax:
Practice Address - Street 1:2172 BLACKBERRY DR STE 204
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-1106
Practice Address - Country:US
Practice Address - Phone:630-262-3327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily