Individual
ALEXIS ODUYALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
60 REVERE DR STE 100, NORTHBROOK, IL 60062-1590
(224) 306-1879
(224) 306-1878
Mailing address
108 W MARKET ST, BLOOMINGTON, IL 61701-3918
(309) 827-5351
(309) 829-6808
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209023210
IL
Other
Enumeration date
03/27/2014
Last updated
10/11/2022
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