Individual
ABIDEMI BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
410 N 2ND ST, MARSHALL, IL 62441-1010
(718) 506-1115
Mailing address
1372 FARGO AVE APT B, DES PLAINES, IL 60018-2991
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209028750
IL
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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