Most Relevant Information
Provider Data
| NPI Number: | 1003381757 |
| Provider Name: | SEGUN BABATUNDE OGUNTOBA FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.018124 |
Most Important Dates
| Enumeration Date: | 10/09/2018 |
| Last Updated: | 04/28/2021 |
Provider Practice Location
901 S AUSTIN BLVD
CHICAGO
IL
606445311
Practice Location Phone/Fax
| Phone: | 7732875959 |
| Fax: |
Provider Mailing Location
5132 N ELSTON AVE
CHICAGO
IL
606302429
Provider Mailing Phone/Fax
| Phone: | 8472356130 |
| Fax: |