Provider Demographics
NPI:1932511920
Name:AKINRINADE, KEHINDE
Entity Type:Individual
Prefix:MR
First Name:KEHINDE
Middle Name:
Last Name:AKINRINADE
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:ADEBUNMI
Other - Middle Name:
Other - Last Name:RAJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2065 W JARVIS AVE
Mailing Address - Street 2:APT 2W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2305
Mailing Address - Country:US
Mailing Address - Phone:773-383-5953
Mailing Address - Fax:
Practice Address - Street 1:2065 W JARVIS AVE
Practice Address - Street 2:APT 2W
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2305
Practice Address - Country:US
Practice Address - Phone:773-383-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA25650475122171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor