Provider Demographics
NPI:1447006499
Name:RESOMA LLC
Entity type:Organization
Organization Name:RESOMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:BIMBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORANBINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-297-4382
Mailing Address - Street 1:18451 CARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2479
Mailing Address - Country:US
Mailing Address - Phone:773-297-4382
Mailing Address - Fax:773-297-4382
Practice Address - Street 1:18451 CARRINGTON CT
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2479
Practice Address - Country:US
Practice Address - Phone:773-297-4382
Practice Address - Fax:773-297-4382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty