Individual provider · NPI-1

Olusola A. Ajilore, M.D.

Psychiatry & Neurology, Psychiatry · Chicago, IL

NPI number1740213347
StatusActive
Last updated in NPPESMar 23, 2010

Details

NPI
1740213347
Entity type
Individual (NPI-1)
Name
Olusola A. Ajilore
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jul 8, 2006
Last updated
Mar 23, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, Psychiatry036123820ILYes
2084P0805X A84869CA

Practice location

912 S Wood St
Chicago, IL 60612-4300

Phone 312-996-7206

Mailing address

912 S Wood St
Chicago, IL 60612-4300

Phone 312-996-7206

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