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Individual

DR. MOTUNRAYO ADISA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
554 GREEN BAY RD STE E, KENILWORTH, IL 60043-1086
(312) 483-4397
Mailing address
60 E DELAWARE PL STE 1450, CHICAGO, IL 60611-6559
(312) 483-4397

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036125295
IL
207ND0900X
Dermatopathology Physician
036125295
IL
207ND0900X
Dermatopathology Physician
256848
MA
207R00000X
Internal Medicine Physician
125-052-665
IL

Other

Enumeration date
11/20/2007
Last updated
01/21/2025
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