Provider Demographics
NPI:1871792986
Name:SODIMU, MARY OLUDUNKE (DPT)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:OLUDUNKE
Last Name:SODIMU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:OLUDUNKE
Other - Last Name:ADEGBITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2150 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5604
Mailing Address - Country:US
Mailing Address - Phone:847-755-0735
Mailing Address - Fax:
Practice Address - Street 1:2150 W GOLF RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5604
Practice Address - Country:US
Practice Address - Phone:847-755-0735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist