Provider Demographics
NPI:1417632407
Name:IRUOLAGBE, CHRISTOPHER OJEMIEGA (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:OJEMIEGA
Last Name:IRUOLAGBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S WHITE OAK DR APT 1725
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-8359
Mailing Address - Country:US
Mailing Address - Phone:312-687-9943
Mailing Address - Fax:
Practice Address - Street 1:3333 GREEN BAY ROAD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:847-578-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2025-07-17
Deactivation Date:2024-01-25
Deactivation Code:
Reactivation Date:2024-03-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program