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Individual

MRS. MOPELOLA O FATUGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1005 HEATHROW CT, WHEATON, IL 60189-7774
(312) 523-4742
(630) 752-0980
Mailing address
1005 HEATHROW CT, WHEATON, IL 60189-7774
(312) 523-4742
(630) 752-0980

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
400449
IL
163WH0200X
Home Health Registered Nurse
Primary
1011561
IL
376J00000X
Homemaker
3001137
IL

Other

Enumeration date
11/14/2015
Last updated
11/14/2015
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