Deborah Olubukunola Oyelowo
Individual provider Active NPI Family Nurse Practitioner · Evergreen PK, IL
NPI 1003552779 · NPPES record last updated May 6, 2022
Key facts
- NPI
- 1003552779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209024995 (IL)
- Practice address
- 2800 W 95TH St
Evergreen PK, IL 60805-2701 - Phone
- (708) 422-6200
- NPI assigned
- May 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 499-2070
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Osf Little Company of Mary Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Am PM Home Healthcare Services LLC |
Home health agency | Corporate Director (50%) W-2 Managing Employee (50%) |
Jan 2, 2023 Jan 2, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220802001290 | IL | Practitioner - Nurse Practitioner | 9335521731 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Am PM Home Healthcare Services LLC | Past |
Accepting new patients |
Locations
2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209024995 | IL | Yes |
Addresses
Primary practice location
2800 W 95TH St
Evergreen PK, IL 60805-2701
Mailing address
9340 S Albany Ave
Evergreen Park, IL 60805-2420
Other providers in Evergreen PK, IL
- Fresenius Medical Care
- Illiana Diagnostics, LLC
- Naomi Knox
- Chiquita Lee
- N'Courage Counseling and Consultation Services, PLLC
- Antoinette Sallamme
- Servant of Peace LLC
- Tamika St. Clair
- Unicolive Home Healthcare Services Inc
All providers in Evergreen PK, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.