Provider Demographics
NPI:1306623517
Name:AJASA, OLUWABUSAYO OLAYINKA (DNP, WHNP-BC)
Entity type:Individual
Prefix:DR
First Name:OLUWABUSAYO
Middle Name:OLAYINKA
Last Name:AJASA
Suffix:
Gender:F
Credentials:DNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 W BLACKHAWK ST APT BF
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2304
Mailing Address - Country:US
Mailing Address - Phone:708-979-2760
Mailing Address - Fax:
Practice Address - Street 1:1414 W BLACKHAWK ST APT BF
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2304
Practice Address - Country:US
Practice Address - Phone:708-979-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028249207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology