Provider Demographics
NPI:1144091760
Name:ADEOYE, BOLARINWA
Entity type:Individual
Prefix:
First Name:BOLARINWA
Middle Name:
Last Name:ADEOYE
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 1:2521 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2161
Mailing Address - Country:US
Mailing Address - Phone:708-858-2939
Mailing Address - Fax:708-889-6317
Practice Address - Street 1:2521 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2161
Practice Address - Country:US
Practice Address - Phone:708-858-2939
Practice Address - Fax:708-889-6317
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041384097163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse