Provider Demographics
NPI:1184361024
Name:CODED HEALTHCARE & BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:CODED HEALTHCARE & BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:OLADUNNI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLADALE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:630-943-0412
Mailing Address - Street 1:494 W BOUGHTON RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1881
Mailing Address - Country:US
Mailing Address - Phone:630-943-0412
Mailing Address - Fax:630-358-6841
Practice Address - Street 1:494 W BOUGHTON RD STE 2B
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1881
Practice Address - Country:US
Practice Address - Phone:630-207-3489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty