Individual
DR. OLAOLUWA O. BODE-OMOLEYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7809 100TH ST, PLEASANT PRAIRIE, WI 53158-2806
(262) 345-2358
(262) 912-0137
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
036149602
IL
207ZD0900X
Dermatopathology (Pathology) Physician
85659-20
WI
207ZH0000X
Hematology (Pathology) Physician
036149602
IL
207ZH0000X
Hematology (Pathology) Physician
85659-20
WI
207ZP0101X
Anatomic Pathology Physician
036149602
IL
207ZP0101X
Anatomic Pathology Physician
Primary
85659-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.149602
ILLINOIS STATE DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
05/06/2013
Last updated
09/14/2025
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