Individual
DR. OMOTOLA WASILAT DANMOLE-ODIMAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, DNP
Contact information
Practice address
2041 W ILES AVE STE C, SPRINGFIELD, IL 62704-7006
(217) 718-2910
Mailing address
2041 W ILES AVE STE C, SPRINGFIELD, IL 62704-7006
(217) 718-2910
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.006961
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.006961
IL
Other
Enumeration date
06/05/2007
Last updated
12/16/2025
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