Provider Demographics
NPI:1891219200
Name:AFUWAPE, OLUWASEYI
Entity Type:Individual
Prefix:
First Name:OLUWASEYI
Middle Name:
Last Name:AFUWAPE
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 1:2339 N CALIFORNIA AVE UNIT 47949
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-0360
Mailing Address - Country:US
Mailing Address - Phone:312-458-9865
Mailing Address - Fax:773-305-8082
Practice Address - Street 1:3048 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6624
Practice Address - Country:US
Practice Address - Phone:312-458-9865
Practice Address - Fax:773-305-8082
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant