Olujimi, Anthony

Olujimi, Anthony is an individual health care provider with primary practice located at 15475 S Park Ave Ste 109 , South Holland IL 60473-1377. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Olujimi, Anthony can be contacted via phone (708) 596-5680.

Contact Information

Primary practice address
15475 S Park Ave Ste 109 South Holland IL 60473-1377
Phone: (708) 596-5680
Fax: (708) 596-5687
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X IL-10172-M Illinois

Profile Details

NPI number 1114432564
LBN Legal business name Olujimi, Anthony
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2017
Last updated Jul 8th, 2021 - about 3 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 1114432564 NPPES
Illinois MEDICAID CA52120001A

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