Individual
MS. OMOTOLA IYADUNNI BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
21209 SHANNON AVE, MATTESON, IL 60443-1460
(708) 720-3315
Mailing address
2 OLYMPUS DR, TINLEY PARK, IL 60477-4827
(708) 263-5222
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056015476
IL
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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