Provider Demographics
NPI:1447652987
Name:OLATUNJI, CHRISTIANAH O
Entity type:Individual
Prefix:MRS
First Name:CHRISTIANAH
Middle Name:O
Last Name:OLATUNJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W WASHINGTON ST STE B-11
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8214
Mailing Address - Country:US
Mailing Address - Phone:630-636-6892
Mailing Address - Fax:630-636-9152
Practice Address - Street 1:123 W WASHINGTON ST STE B-11
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8214
Practice Address - Country:US
Practice Address - Phone:630-636-6892
Practice Address - Fax:630-636-9152
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000701376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker