| NPI | 1245936053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELEKE OGUNSOLA Manager 708-856-5909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2024-02-15 |