Provider Demographics
NPI:1770467300
Name:OGUNDIPE, KIKELOMO IFEOLU (RN)
Entity type:Individual
Prefix:MRS
First Name:KIKELOMO
Middle Name:IFEOLU
Last Name:OGUNDIPE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 W. PETERSON AVENUE
Mailing Address - Street 2:SUITE T10
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659
Mailing Address - Country:US
Mailing Address - Phone:630-222-7555
Mailing Address - Fax:630-333-4598
Practice Address - Street 1:3525 W. PETERSON AVENUE
Practice Address - Street 2:SUITE T10
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659
Practice Address - Country:US
Practice Address - Phone:630-222-7555
Practice Address - Fax:630-333-4598
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.579919251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health