Provider Demographics
NPI:1861149601
Name:ADENIJI, OLUWASHOLA ADEBOLA (RN)
Entity type:Individual
Prefix:
First Name:OLUWASHOLA
Middle Name:ADEBOLA
Last Name:ADENIJI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:OLUWASHOLA
Other - Middle Name:ADEBOLA
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5660 CAMBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-3658
Mailing Address - Country:US
Mailing Address - Phone:773-430-2222
Mailing Address - Fax:
Practice Address - Street 1:5660 CAMBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-3658
Practice Address - Country:US
Practice Address - Phone:773-430-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.481397163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse