Awofadeju, Ayoola Samuel

Awofadeju, Ayoola Samuel is an sole proprietor health care provider with primary practice located at 3703 Ballantrae Way , Flossmoor IL 60422-4316. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Awofadeju, Ayoola Samuel can be contacted via phone (708) 955-6415.

Contact Information

Primary practice address
3703 Ballantrae Way Flossmoor IL 60422-4316
Phone: (708) 955-6415
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01063569A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036102150 Illinois
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 036102150 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036102150 Illinois

Profile Details

NPI number 1760423461
LBN Legal business name Awofadeju, Ayoola Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2006
Last updated May 19th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760423461 NPPES
Illinois MEDICAID 036102150-8
Illinois Other P00163002
Illinois MEDICAID 036102150
Illinois MEDICAID 200800750

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