Individual
DR. AGBOOLA AWOMOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 878-8700
Mailing address
15537 INGLESIDE AVE, DOLTON, IL 60419-2759
(773) 430-1254
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3694807
IL
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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