Basic Information
| Provider Information | |||||||||
| NPI: | 1811615834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OYEBANJI | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | OLUWATOSIN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3010 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | WAUKEGAN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600852321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473778000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 423 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | ROUND LAKE PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600733018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473778950 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2022 | ||||||||
| LastUpdateDate: | 08/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.