Individual
EKIOMOADO AGNES OLUMESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
1136 S DELANO CT W APT 303, CHICAGO, IL 60605-3734
(301) 275-7950
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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