Provider Demographics
NPI:1467295287
Name:LASAKI, OLUYEMI ELIZABETH (PMHNP)
Entity type:Individual
Prefix:
First Name:OLUYEMI
Middle Name:ELIZABETH
Last Name:LASAKI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20855 S LAGRANGE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2043
Mailing Address - Country:US
Mailing Address - Phone:773-985-3539
Mailing Address - Fax:773-825-8411
Practice Address - Street 1:20855 S LAGRANGE RD STE 205
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2043
Practice Address - Country:US
Practice Address - Phone:773-985-3539
Practice Address - Fax:773-825-8411
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.029884363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty