Provider Demographics
NPI:1184883514
Name:ALI, BABATUNDE O
Entity type:Individual
Prefix:MR
First Name:BABATUNDE
Middle Name:O
Last Name:ALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15711 PAULINA ST
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-4226
Mailing Address - Country:US
Mailing Address - Phone:773-209-1994
Mailing Address - Fax:773-854-5868
Practice Address - Street 1:15711 PAULINA ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-4226
Practice Address - Country:US
Practice Address - Phone:773-209-1994
Practice Address - Fax:773-854-5868
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist