Provider Demographics
NPI:1598420051
Name:APATA, TEMITOPE ADEYINKA (NP)
Entity type:Individual
Prefix:
First Name:TEMITOPE
Middle Name:ADEYINKA
Last Name:APATA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 W BOUGHTON RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1881
Mailing Address - Country:US
Mailing Address - Phone:331-246-6564
Mailing Address - Fax:630-358-6841
Practice Address - Street 1:494 W BOUGHTON RD STE 2B
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1881
Practice Address - Country:US
Practice Address - Phone:331-246-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023984363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health