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Individual

MRS. MODINAT IRETIOLUWA BOKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
300 E MAZON AVE, DWIGHT, IL 60420-1197
(815) 584-1240
Mailing address
1541 STEFANIE LN, BOURBONNAIS, IL 60914-9672
(630) 888-0868

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
057005250
IL

Other

Enumeration date
12/12/2021
Last updated
12/12/2021
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