Provider Demographics
NPI:1881467447
Name:OSHOKOYA, IDOWU O (APRN)
Entity type:Individual
Prefix:
First Name:IDOWU
Middle Name:O
Last Name:OSHOKOYA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20550 S LAGRANGE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1811
Mailing Address - Country:US
Mailing Address - Phone:312-878-5588
Mailing Address - Fax:312-900-9373
Practice Address - Street 1:20550 S LAGRANGE RD STE 3
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1811
Practice Address - Country:US
Practice Address - Phone:312-878-5588
Practice Address - Fax:312-900-9373
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028659363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health