Provider Demographics
NPI:1255753679
Name:OYELAMI, IFEFIKAYO (DPT)
Entity type:Individual
Prefix:MR
First Name:IFEFIKAYO
Middle Name:
Last Name:OYELAMI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 N WINCHESTER AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1587
Mailing Address - Country:US
Mailing Address - Phone:773-870-9706
Mailing Address - Fax:
Practice Address - Street 1:2649 E 75TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3835
Practice Address - Country:US
Practice Address - Phone:773-721-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist