Organization
PATIENCE O. ADESIDA M.D. LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATIENCE OKPAKU ADESIDA M.D. (PHYSICIAN/PRESIDENT.)
(217) 239-6667
Entity
Organization
Contact information
Practice address
2008 N MARKET ST, CHAMPAIGN, IL 61822-1308
(217) 239-6667
(217) 239-6670
Mailing address
2008 N MARKET ST, CHAMPAIGN, IL 61822-1308
(217) 239-6667
(217) 239-6670
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036075310
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075310
—
IL
Enumeration date
04/01/2008
Last updated
07/16/2008
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