Individual
OLADIPUPO SHOYOMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 W MELROSE ST APT 330, CHICAGO, IL 60657-3818
(800) 253-6973
Mailing address
450 W MELROSE ST APT 330, CHICAGO, IL 60657-3818
(800) 253-6973
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
3001998
IL
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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