Provider Demographics
NPI:1487886479
Name:ADEBAYO, MARGARET CECILIA (DT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:CECILIA
Last Name:ADEBAYO
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WARWICK STREET
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-1621
Mailing Address - Country:US
Mailing Address - Phone:708-926-4714
Mailing Address - Fax:708-248-5823
Practice Address - Street 1:104 WARWICK ST
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-1621
Practice Address - Country:US
Practice Address - Phone:708-926-4714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2028618222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL222Q00000XOtherN/A