Individual
OLALEKAN OLUMUYIWA FASOGBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
10935 S HALSTED ST, CHICAGO, IL 60628-3127
(773) 419-0138
Mailing address
11724 S JUSTINE ST, CHICAGO, IL 60643-5028
(773) 419-0138
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.032300
IL
Other
Enumeration date
04/30/2025
Last updated
08/13/2025
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