Individual
FUNMILAYO TADE ADEWALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(678) 717-9084
Mailing address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
036156228
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036156228
IL
2085R0202X
Diagnostic Radiology Physician
2023049401
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
05/13/2026
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