Individual
GRACE IYABO KOMOLAFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 W HARLEM AVE, MONMOUTH, IL 61462-1007
(309) 734-3141
(309) 734-3029
Mailing address
1000 W HARLEM AVE, MONMOUTH, IL 61462-1007
(309) 734-3141
(309) 734-3029
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036158512
IL
207P00000X
Emergency Medicine Physician
28344
WV
207P00000X
Emergency Medicine Physician
302898
NY
207Q00000X
Family Medicine Physician
21826
NH
Other
Enumeration date
05/27/2015
Last updated
08/15/2024
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