Individual
OYEYEMI ANTHONY SHODIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15928 LECLAIRE AVE APT A206, OAK FOREST, IL 60452-3911
(708) 864-1818
Mailing address
15928 LECLAIRE AVE APT A206, OAK FOREST, IL 60452-3911
(708) 864-1818
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041463053
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209025058
IL
Other
Enumeration date
02/28/2022
Last updated
04/05/2022
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