Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Oluwafisayo Jebutu

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992405385

Oluwafisayo Jebutu is a Student in an Organized Health Care Education/Training Program in Champaign, Illinois. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

1902 N Prospect Ave Ste 1
Champaign, IL 61822-1411
Phone: (217) 408-2511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3302 Gaston Ave, Dallas, TX 75246-2013 — (214) 828-8215

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019034360 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1992405385
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 6, 2023
Last updated in NPPESJune 9, 2023
Certification dateJune 9, 2023
Mailing address1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411

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