Provider Demographics
NPI:1508674185
Name:OBAFAYE, KAREEM TUNDE
Entity type:Individual
Prefix:MR
First Name:KAREEM
Middle Name:TUNDE
Last Name:OBAFAYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9021 FEDERAL CT APT 2D
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5045
Mailing Address - Country:US
Mailing Address - Phone:781-363-8253
Mailing Address - Fax:
Practice Address - Street 1:9021 FEDERAL CT APT 2D
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5045
Practice Address - Country:US
Practice Address - Phone:781-363-8253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILO11051877085343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)