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Individual

ADEKUNBI BAKIAT ADEFESO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4008 N CICERO AVE, CHICAGO, IL 60641-1807
(312) 300-7386
Mailing address
3347 CHURCH ST, EVANSTON, IL 60203-1722

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034679
IL

Other

Enumeration date
06/27/2023
Last updated
12/10/2024
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