Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIMOTHY OMOTAYO ADESANYA
ActiveMedical Physician Assistant · HILLIBORO, IL
Registration Details
- NPI Number
- 1467001859
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 9, 2019 (6.6166248599224 yrs)
- Last Updated
- Sep 9, 2019
- License
-
085001089 (IL)
Practice Information
- Address
-
GRAHAM CORRECTIONAL CENTER12078 ILLINOIS RTE 185HILLIBORO, IL, 62049Browse IL providers · Browse ZIP 62049
- Phone
- 2175326961
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.