Individual
OMOLARA OLADUNNI AYODELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3000
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
014.361780
IL
363LA2200X
Adult Health Nurse Practitioner
209.012588
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209.012588
IL
Other
Enumeration date
03/12/2015
Last updated
03/01/2019
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