Provider Demographics
NPI:1770145278
Name:AMORANBINI, BIMBOLA MUFLIAT (PMHNP)
Entity type:Individual
Prefix:
First Name:BIMBOLA
Middle Name:MUFLIAT
Last Name:AMORANBINI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:BIMBOLA
Other - Middle Name:MUFLIAT
Other - Last Name:AMORANBINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP
Mailing Address - Street 1:18451 CARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2479
Mailing Address - Country:US
Mailing Address - Phone:773-297-4382
Mailing Address - Fax:
Practice Address - Street 1:8900 S COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6321
Practice Address - Country:US
Practice Address - Phone:773-275-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019526363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health