Provider Demographics
NPI:1770038192
Name:OLAOYE, IDAYAT (RN, BSN)
Entity Type:Individual
Prefix:
First Name:IDAYAT
Middle Name:
Last Name:OLAOYE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-2537
Mailing Address - Country:US
Mailing Address - Phone:708-612-1144
Mailing Address - Fax:
Practice Address - Street 1:3612 LINCOLN HWY STE 19
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1637
Practice Address - Country:US
Practice Address - Phone:708-612-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3001392253Z00000X
IL4000526251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care