Provider Demographics
NPI:1508292616
Name:ALIMI-UKOHA, ADETOWUN O (DDS)
Entity type:Individual
Prefix:
First Name:ADETOWUN
Middle Name:O
Last Name:ALIMI-UKOHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 FLOSSMOOR RD
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1141
Mailing Address - Country:US
Mailing Address - Phone:708-799-9755
Mailing Address - Fax:
Practice Address - Street 1:2711 FLOSSMOOR RD
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1141
Practice Address - Country:US
Practice Address - Phone:708-799-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029597122300000X
IL021.0033711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist