Ajilore, Olusola A.

Ajilore, Olusola A. is an individual health care provider with primary practice located at 912 S Wood St , Chicago IL 60612-4300. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Ajilore, Olusola A. can be contacted via phone (312) 996-7206.

Contact Information

Primary practice address
912 S Wood St Chicago IL 60612-4300
Phone: (312) 996-7206
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X A84869 California
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036123820 Illinois

Profile Details

NPI number 1740213347
LBN Legal business name Ajilore, Olusola A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Mar 23rd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740213347 NPPES
California MEDICAID 00A848690

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