Provider Demographics
NPI:1578355723
Name:IJAOLA, MAYOWA STELLA (BSN)
Entity type:Individual
Prefix:
First Name:MAYOWA
Middle Name:STELLA
Last Name:IJAOLA
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 S RIDGELAND AVE APT 2S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-2047
Mailing Address - Country:US
Mailing Address - Phone:847-414-6733
Mailing Address - Fax:
Practice Address - Street 1:6750 S RIDGELAND AVE APT 2S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2047
Practice Address - Country:US
Practice Address - Phone:847-414-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemaker
No251J00000XAgenciesNursing Care