Provider Demographics
NPI:1932097011
Name:ADELEKE, OLUWASEUN REGINA (MD)
Entity type:Individual
Prefix:
First Name:OLUWASEUN
Middle Name:REGINA
Last Name:ADELEKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUWASEUN
Other - Middle Name:REGINA
Other - Last Name:IJETE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-6723
Mailing Address - Country:US
Mailing Address - Phone:618-474-1723
Mailing Address - Fax:618-433-6299
Practice Address - Street 1:2 MEMORIAL DR STE 220
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6723
Practice Address - Country:US
Practice Address - Phone:618-474-1723
Practice Address - Fax:618-433-6299
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.087004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine