Individual
ADEWUMI C ODEFADEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-FPA
Contact information
Practice address
1005 S EVERGREEN AVE, ARLINGTON HEIGHTS, IL 60005-3144
(847) 787-3734
(630) 451-9896
Mailing address
1005 S EVERGREEN AVE, ARLINGTON HEIGHTS, IL 60005-3144
(847) 787-3734
(630) 451-9896
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209017467
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209017467
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063900603
—
IL
Enumeration date
04/30/2018
Last updated
04/07/2020
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