Individual
OLUSOLA A. AJILORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-7206
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-7206
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036123820
IL
2084P0805X
Geriatric Psychiatry Physician
A84869
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A848690
—
CA
Enumeration date
07/08/2006
Last updated
03/23/2010
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