Provider Demographics
NPI:1487979076
Name:AKINOLA, VICTOR ADENIYI
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:ADENIYI
Last Name:AKINOLA
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 1:808 SURREY DR
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-2133
Mailing Address - Country:US
Mailing Address - Phone:847-207-2815
Mailing Address - Fax:
Practice Address - Street 1:808 SURREY DR
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-2133
Practice Address - Country:US
Practice Address - Phone:847-207-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000254246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant