Provider Demographics
NPI:1215511589
Name:OYENIYI, ALABA ADEKUNLE
Entity type:Individual
Prefix:
First Name:ALABA
Middle Name:ADEKUNLE
Last Name:OYENIYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 S SOUTH SHORE DR APT 408
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-2751
Mailing Address - Country:US
Mailing Address - Phone:773-366-6002
Mailing Address - Fax:
Practice Address - Street 1:7220 S SOUTH SHORE DR APT 408
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2751
Practice Address - Country:US
Practice Address - Phone:773-366-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician