Mopelola O Fatuga

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

1011561 Issued in IL

Practice address

1005 Heathrow CT
Wheaton, IL 60189-7774

Phone

(312) 523-4742

Fax

(630) 752-0980

NPI assigned

Nov 14, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Royal Compassionate Home Health LLC

  • Home Health Agency
  • Wheaton, IL
  • NPI 1962877969
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447459200000",
    "number": "1003280090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEATHROW CT",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601897774",
            "telephone_number": "312-523-4742",
            "fax_number": "630-752-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEATHROW CT",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601897774",
            "telephone_number": "312-523-4742",
            "fax_number": "630-752-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATUGA",
        "first_name": "MOPELOLA",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-14",
        "last_updated": "2015-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "400449",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "1011561",
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "IL",
            "license": "3001137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyse Dawn Farrar, PA-C
• Christine A Farrell, PT
• Mary Margaret Farrelly
• Briahna Monae Farries
• Julie Farrow, SLP
• Thomas Christian Favale Jr., DVM, LSW
• Izabel M Favela, MA
• Anna Marie Faveron, RN
• Shairoz A Fazal, OD
• Joan L Fefferman, LCPC CADC

• Home Health Registered Nurse in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Home Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.