SAMSON AJIBOLA OMOWUMI

PEORIA, IL
NPI1457181877
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IL  209.030167)
Enumeration Date2024-08-02
Last Update Date2024-08-02
Business Address
SAMSON AJIBOLA OMOWUMI
5401 N KNOXVILLE AVE
PEORIA, IL 61614-5098
Phone number: 614-816-7589
Mailing Address
SAMSON AJIBOLA OMOWUMI
10830 N SAWMILL LN
DUNLAP, IL 61525-7514
Phone number: 614-816-7589
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