Individual
BOLATITO OLUBUKOLA OGUNSANWO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
3707 DOTY RD, WOODSTOCK, IL 60098-7530
(815) 334-5018
(815) 206-2822
Mailing address
3707 DOTY RD, WOODSTOCK, IL 60098-7530
(815) 334-5018
(815) 206-2822
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209028763
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.028763
IL
Other
Enumeration date
01/04/2024
Last updated
07/23/2024
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