Provider Demographics
NPI:1255151775
Name:ADEJUMO, IYABODE OLADUNNI (CNM)
Entity type:Individual
Prefix:DR
First Name:IYABODE
Middle Name:OLADUNNI
Last Name:ADEJUMO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 SKOKIE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2131
Mailing Address - Country:US
Mailing Address - Phone:773-992-6105
Mailing Address - Fax:
Practice Address - Street 1:547 SKOKIE BLVD
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2131
Practice Address - Country:US
Practice Address - Phone:773-992-6105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209030740367A00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife