MRS. BOLANLE OMOLARA SOYANNWO BALOGUN (NPI# 1316122468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316122468 |
| Entity Type | Individual |
| Full Name | MRS. BOLANLE OMOLARA SOYANNWO BALOGUN |
| Other Name | BOLANLE OMOLARA SOYANNWO |
| Credential | M.D |
| Practice Address |
3880 Salem Lake Dr Ste F Long Grove IL 60047 |
| Mailing Address |
3880 Salem Lake Dr Ste F Long Grove IL 60047-5292 |
| Practice Telephone | 8477192220 |
| Practice Fax Number | 8477192265 |
| Mailing Telephone | 8477192220 |
| Mailing Fax Number | 8477192265 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2018-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 125050213 | IL | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 036119645 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEA | FS1021308 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1436 W Harrison St, Apt 3a, Chicago, IL 606073214 | 8725883000 | 8725883001 |
| Street Address |
3880 SALEM LAKE DR STE F |
| City | LONG GROVE |
| State | IL |
| Zip Code | 60047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083662050 | Daniel R. Di Iorio | Chiropractor | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2006-05-04 |
| 1215492491 | Jakeyla Reed | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047 | 2019-02-01 |
| 1790258473 | Punam Subhashchandra Trivede | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2019-01-06 |
| 1760959209 | Latonya Shinese Vaughn | Registered Nurse | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2018-11-01 |
| 1194291237 | Angela Rose Depa | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2018-10-16 |
| 1033694922 | Helen E Okorie | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047 | 2018-09-26 |
| 1376024976 | Agnieszka Nieciunski | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2018-08-22 |
| 1336627165 | Lana Bratko | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2018-08-02 |
| 1942788922 | Shreya Vasavada | Physician Assistant | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2018-08-01 |
| 1265919112 | Christine Laverne Bolden | Nurse Practitioner | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047 | 2018-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871142547 | Terry Solberg | Technician | 25 Robin Crest Rd, Hawthorn Woods, IL 60047 | 2019-09-05 |
| 1073083614 | Cody Colleen Todd | Counselor | 21361 W Brandon Rd, Kildeer, IL 60047 | 2018-11-27 |
| 1861983694 | Ahmad Family Primary Care, S.c. | Family Medicine | 350 Surryse Rd Ste 240, Lake Zurich, IL 60047 | 2018-05-29 |
| 1508371972 | Joy Anne Margolis | Speech-Language Pathologist | 4151 Robert Parker Coffin Rd, Long Grove, IL 60047 | 2017-12-07 |
| 1982118576 | Stephanie Marie Luebbe | Specialist/Technologist | 30 Seneca Ave W, Hawthorn Woods, IL 60047 | 2017-11-19 |
| 1447785498 | Kayla Stavnes | Student in an Organized Health Care Education/Training Program | 23537 N Garden Ln, Lake Zurich, IL 60047 | 2017-04-27 |
| 1104366491 | Lindsay Pearlman & Associates | Psychologist | 4160 Rte 83, Suite 307, Long Grove, IL 60047 | 2017-03-06 |
| 1164969929 | Lauren Christine Hallerud | Counselor | 4180 Il-83, Suite 10, Long Grove, IL 60047 | 2017-01-31 |
| 1790220820 | Long Grove Center for Emotional Health LLC | Counselor | 4180 Rfd, Suite 10, Long Grove, IL 60047 | 2016-12-28 |
| 1063960276 | Mars Healthcare LLC | Clinic/Center | 721 W Highway 22nd, Lake Zurich, IL 60047 | 2016-09-16 |
| Find all providers in zip 60047 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154686525 | Lake County Internal Medicine Associates, LLC | Internal Medicine | 5911 Kildeer Ct, Long Grove, IL 60047-5052 | 2012-07-11 |
| 1316172372 | David A Kanarek M.d. | Internal Medicine | 4160 Illinois Route 83, Suite 303, Long Grove, IL 60047-9586 | 2009-05-20 |
| 1669532941 | Ritu Piplani | Internal Medicine | 3880 Salem Lake Dr., Ste. F, Long Grove, IL 60047 | 2006-12-09 |
| 1053323881 | Annette Corinne Olin | Internal Medicine | 3880 Salem Lake Dr # F, Long Grove, IL 60047 | 2006-08-12 |
| 1437189842 | David A Kanarek | Internal Medicine | Rfd 4160, Suite 304, Long Grove, IL 60047 | 2006-07-03 |
| 1861485153 | Reginald Lafate Spears | Internal Medicine | 4160 Route 83, Suite 207, Long Grove, IL 60047 | 2005-08-23 |
| 1265437230 | Robert J Longo | Internal Medicine | 3880 Salem Lake Dr, Ste F, Long Grove, IL 60047-5292 | 2005-06-16 |
| 1962939538 | Johnny Khamoo | Internal Medicine | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2017-05-15 |
| 1386176659 | Rakesh Marreddy | Internal Medicine | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2017-03-28 |
| 1760923056 | Brian O'byrne | Internal Medicine | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2017-03-20 |
| Find all providers in LONG GROVE | ||||
| City | LONG GROVE |
| Zip Code | 60047 |
Please comment or provide details below to improve the information on MRS. BOLANLE OMOLARA SOYANNWO BALOGUN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.