Provider Demographics
NPI:1386084077
Name:ADEGBOYEGA, ADETUNJI (MD)
Entity type:Individual
Prefix:DR
First Name:ADETUNJI
Middle Name:
Last Name:ADEGBOYEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 OGDEN AVE
Mailing Address - Street 2:STE 325
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5894
Mailing Address - Country:US
Mailing Address - Phone:215-500-4848
Mailing Address - Fax:
Practice Address - Street 1:2020 OGDEN AVE STE 325
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5897
Practice Address - Country:US
Practice Address - Phone:630-978-4850
Practice Address - Fax:630-978-6865
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.064037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine