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Organization
IMPECCABLE GRACE SERVICES PLLC
Active
Organization
IMPECCABLE GRACE SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLALEKAN OLUMUYIWA FASOGBON PMHNP-BC (NP)
(773) 419-0138
Entity
Organization
Contact information
Practice address
11724 S JUSTINE ST FL 1, CHICAGO, IL 60643-5028
(773) 419-0138
(619) 984-4174
Mailing address
11724 S JUSTINE ST FL 1, CHICAGO, IL 60643-5028
(773) 419-0138
(619) 984-4174
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/22/2026
Last updated
09/22/2026
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