Provider Demographics
NPI:1790983690
Name:ABOYEJI, OLUFEMI (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUFEMI
Middle Name:
Last Name:ABOYEJI
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 1:430 E 162ND ST # 487
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2258
Mailing Address - Country:US
Mailing Address - Phone:708-960-4280
Mailing Address - Fax:708-960-0390
Practice Address - Street 1:17901 GOVERNORS HWY # 209
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1144
Practice Address - Country:US
Practice Address - Phone:708-960-4280
Practice Address - Fax:708-960-0390
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01069941A207RI0200X
IL125052120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036119718Medicaid
IL036119718Medicaid
IL594180Medicare PIN