| NPI | 1184361024 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | OLADUNNI BOLADALE Nurse Practitioner 630-943-0412  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Enumeration Date | 2022-05-12 | 
| Last Update Date | 2023-09-21 |