Individual
MOJISOLA LATEEFAT LUGBOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGENCY MANAGER
Contact information
Practice address
8045 S CHRISTIANA AVE, CHICAGO, IL 60652-2511
(773) 742-7434
Mailing address
8045 S CHRISTIANA AVE, CHICAGO, IL 60652-2511
(773) 742-7434
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043107697
IL
Other
Enumeration date
01/29/2024
Last updated
10/28/2024
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