Provider Demographics
NPI:1457121246
Name:ADELEYE, BABAJIDE IDOWU (APN)
Entity type:Individual
Prefix:
First Name:BABAJIDE
Middle Name:IDOWU
Last Name:ADELEYE
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARLTON AT THE LAKE REHABILITATION CENTER
Mailing Address - Street 2:725 W MONTROSE AVENUE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613
Mailing Address - Country:US
Mailing Address - Phone:773-929-1700
Mailing Address - Fax:773-929-3068
Practice Address - Street 1:4050 HEALTHWAY DR STE 140
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8184
Practice Address - Country:US
Practice Address - Phone:815-409-5117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041425108363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health