Odefadehan, Adewumi C

Odefadehan, Adewumi C is an individual health care provider with primary practice located at 1005 S Evergreen Ave , Arlington Heights IL 60005-3144. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Odefadehan, Adewumi C can be contacted via phone (847) 787-3734.

Contact Information

Primary practice address
1005 S Evergreen Ave Arlington Heights IL 60005-3144
Phone: (847) 787-3734
Fax: (630) 451-9896
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209017467 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 209017467 Illinois

Profile Details

NPI number 1063900603
LBN Legal business name Odefadehan, Adewumi C
Credentials APRN-FPA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2018
Last updated Apr 7th, 2020 - about 4 years ago

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 1063900603 NPPES
Illinois MEDICAID 1063900603

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