Provider Demographics
NPI:1124688213
Name:ISOLA, ATINUKE C (CLC)
Entity type:Individual
Prefix:MISS
First Name:ATINUKE
Middle Name:C
Last Name:ISOLA
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 N DELPHIA AVE APT 122
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-4620
Mailing Address - Country:US
Mailing Address - Phone:224-475-9604
Mailing Address - Fax:
Practice Address - Street 1:5321 N DELPHIA AVE APT 122
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-4620
Practice Address - Country:US
Practice Address - Phone:224-475-9604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILALPP-282106174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN