TIMOTHY OMOTAYO ADESANYA

HILLIBORO, IL
NPI1467001859
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: IL  085001089)
Enumeration Date2019-09-09
Last Update Date2019-09-09
Business Address
TIMOTHY OMOTAYO ADESANYA
GRAHAM CORRECTIONAL CENTER 12078 ILLINOIS RTE 185
HILLIBORO, IL 62049
Phone number: 217-532-6961
Mailing Address
TIMOTHY OMOTAYO ADESANYA
PO BOX 512
GREENVILLE, IL 62246-0512
Phone number: 618-664-2914