Provider Demographics
NPI:1447515374
Name:ADARAMOLA, DORCAS OLUDIMIMU (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:DORCAS
Middle Name:OLUDIMIMU
Last Name:ADARAMOLA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:DORCAS
Other - Middle Name:IDOWU
Other - Last Name:ADESOKAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19636
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9636
Mailing Address - Country:US
Mailing Address - Phone:217-545-8000
Mailing Address - Fax:217-545-7163
Practice Address - Street 1:751 N RUTLEDGE ST STE 2100
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-4968
Practice Address - Country:US
Practice Address - Phone:217-545-8000
Practice Address - Fax:217-545-7063
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-143313207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-143313OtherSTATE LICENSE