1770467300 NPI number — MRS. KIKELOMO IFEOLU OGUNDIPE R.N.

Table of content: MRS. KIKELOMO IFEOLU OGUNDIPE R.N. (NPI 1770467300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770467300 NPI number — MRS. KIKELOMO IFEOLU OGUNDIPE R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OGUNDIPE
Provider First Name:
KIKELOMO
Provider Middle Name:
IFEOLU
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770467300
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3525 W. PETERSON AVENUE
Provider Second Line Business Mailing Address:
SUITE T10
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-222-7555
Provider Business Mailing Address Fax Number:
630-333-4598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3525 W. PETERSON AVENUE
Provider Second Line Business Practice Location Address:
SUITE T10
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-222-7555
Provider Business Practice Location Address Fax Number:
630-333-4598
Provider Enumeration Date:
08/05/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  041.579919 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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