Individual
AYODELE AGUNBIADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
704 E 44TH ST, CHICAGO, IL 60653-3541
(773) 451-0600
(773) 451-0600
Mailing address
704 E 44TH ST, CHICAGO, IL 60653-3541
(773) 451-0600
(773) 451-0600
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
010699300
IL
Other
Enumeration date
12/21/2009
Last updated
07/30/2016
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