Joseph Olatunde Ayoola, RN
Individual provider Active NPI General Practice Registered Nurse · Flossmoor, IL
NPI 1154584951 · NPPES record last updated Jul 2, 2008
Key facts
- NPI
- 1154584951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Registered Nurse 163WG0000X
- License
- 041-263525 (IL)
- Practice address
- 3914 Ballantrae Way
Flossmoor, IL 60422-4378 - Phone
- (708) 217-8595
- NPI assigned
- Jul 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-263525 | IL | MD | General Practice Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 041-263525 | IL | Yes |
Addresses
Primary practice location
3914 Ballantrae Way
Flossmoor, IL 60422-4378
Mailing address
3914 Ballantrae Way
Flossmoor, IL 60422-4378
Phone (708) 217-8595
Other providers in Flossmoor, IL
- Athletico, LTD
- Awakened Alternatives Enterprises
- Awakened Alternatives Inc
- Awakened Alternatives Inc.
- Ayoola Samuel Awofadeju
- Lekha Babu
- Andrea Bacon
- Rolanda Bailey-Clark
- Sonya R Baker
- Daniel L Ballard
All providers in Flossmoor, IL · General Practice Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.