Individual
BUKOLA EUNICE ADEAGBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 975-6775
Mailing address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 975-6775
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209019375
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209019375
MEDICAL LICENSE
IL
Enumeration date
07/11/2019
Last updated
04/14/2025
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