Provider Demographics
NPI:1104611185
Name:GBEMIKAIYE, BASIRAT OLAIDE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BASIRAT
Middle Name:OLAIDE
Last Name:GBEMIKAIYE
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18145 CHARLOTTE DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18145 CHARLOTTE DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2272
Practice Address - Country:US
Practice Address - Phone:765-409-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71510961835C0205X
IL3080100221835P1200X
IL051291884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835C0205XPharmacy Service ProvidersPharmacistCritical Care
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy