Segun Babatunde Oguntoba, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.018124 Issued in IL

Practice address

901 S Austin Blvd
Chicago, IL 60644-5311

Phone

(773) 287-5959

NPI assigned

Oct 9, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Cook County

  dba John H. Stroger, Jr. Hospital of Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL

  Medicare reassignment NPD
• Cook County

  dba Cook County Health & Hospitals System Physician Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  dba Bronzeville Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• John H Stroger Jr Hospital Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1992914733
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1003381757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302429",
            "telephone_number": "847-235-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S AUSTIN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606445311",
            "telephone_number": "773-287-5959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4035 S Ellis Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606532407",
            "country_code": "US",
            "telephone_number": "773-615-4009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNTOBA",
        "first_name": "SEGUN",
        "middle_name": "BABATUNDE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.018124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "segun.oguntoba@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Simi Ogunnowo
• Grace Ogunnubi
• Franklyn B Oguno, PA-C
• Folashade Ogunsanya, D
• Kayode Bolaji Ogunsola
• Gary Roman Ogurkiewicz, DC
• Stephen Bryan Ogwang
• Alison Oh, LCPC
• Dong Gue Oh, MD
• Eugene Oh, MD

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.