Individual provider Active NPI

Mayowa Ogunfowokan, APRN, CNP

  • Nurse Practitioner
  • Winfield, IL
National Provider Identifier
1063046092
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020969 Issued in IL
Practice address
25 N Winfield Rd Ste 500
Winfield, IL 60190-1379
Phone
(630) 232-0280
Fax
(630) 232-3895
NPI assigned
Feb 28, 2020
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209020969 IL Primary
Family Nurse Practitioner 363LF0000X 209020969 IL

Addresses

Primary practice location

25 N Winfield Rd Ste 500
Winfield, IL 60190-1379

Mailing address

25 N Winfield Rd Ste 500
Winfield, IL 60190-1379
Phone (630) 232-0280

Other practice location 1

351 Delnor Dr Ste 302
Geneva, IL 60134-4233
Phone (630) 232-0280

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200522000182 IL Practitioner - Nurse Practitioner 6204257538 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loyola University of Chicago, Stritch School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

233 S Gary Ave
Bloomingdale, IL 60108-2213
Phone (630) 358-4414

235 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2213
Phone (630) 893-9600

2635 Church Rd
Suite 101
Aurora, IL 60502-8943
Phone (630) 315-6900

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

7 Blanchard Cir
Wheaton, IL 60189-2038

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 20, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 4, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 4, 2024 Accepting new patients
Copley Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Jan 1, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince May 20, 2020 Accepting new patients

Locations

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

Dept 5777
Carol Stream, IL 60122

351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001

351 Delnor Dr
Ste 302
Geneva, IL 60134
Phone (630) 202-0280

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

0N025 Winfield Rd
Winfield, IL 60190
Phone (630) 832-0050

25 N Winfield Rd
Ste 500
Winfield, IL 60190
Phone (630) 232-2800

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1063046092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD STE 500",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD STE 500",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Delnor Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344233",
            "country_code": "US",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNFOWOKAN",
        "first_name": "MAYOWA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-28",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020969",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.