Individual
IBUKUN AYODEJI DUROSANYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9964 HOLLY LN APT 2N, DES PLAINES, IL 60016-1416
(779) 777-4174
Mailing address
9964 HOLLY LN APT 2N, DES PLAINES, IL 60016-1416
(779) 777-4174
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
041572103
IL
163WG0000X
General Practice Registered Nurse
041572103
IL
163WI0500X
Infusion Therapy Registered Nurse
041572103
IL
163WW0000X
Wound Care Registered Nurse
Primary
041572103
IL
Other
Enumeration date
05/19/2025
Last updated
08/12/2025
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