Individual provider · Type 1 NPI

Omolola Nicole Ometoruwa

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1962298398 Active

Practice location

3501 N Halsted St
Chicago, IL 60657-1832

Call (773) 388-1600 Map

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X085.012277 (IL)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1962298398

Omolola Nicole Ometoruwa's National Provider Identifier is 1962298398, issued on Apr 15, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on Aug 4, 2026.