# PATIENCE O. ADESIDA M.D. LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609048495
- **Authorized official:** DR. PATIENCE OKPAKU ADESIDA M.D. (PHYSICIAN/PRESIDENT.)
- **Authorized official phone:** (217) 239-6667

## Contact information

- **Practice address:** 2008 N MARKET ST, CHAMPAIGN, IL 61822-1308
- **Practice address phone:** (217) 239-6667
- **Practice address fax:** (217) 239-6670
- **Mailing address:** 2008 N MARKET ST, CHAMPAIGN, IL 61822-1308
- **Mailing address phone:** (217) 239-6667
- **Mailing address fax:** (217) 239-6670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 036075310 | IL | Yes |

## Other

- **Enumeration date:** 04/01/2008
- **Last updated:** 07/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036075310 | — | IL |