| NPI | 1205417573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIFAT FOLASHADE ADELEKAN-ADEOGUN Psychiatric Nurse Practitioner 224-578-2132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2022-02-09 |