Ayodeji K Kofoworola, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.028835 Issued in IL

Practice address

1129 Emerson St
Evanston, IL 60201-3131

Phone

(800) 974-4378

Fax

(630) 515-1536

NPI assigned

Dec 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• DPT Holdings PLLC

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602

  IL, Physical Therapist

  Medicare reassignment Care Compare group NPD
• DPT Holdings PLLC

  • Occupational Therapist
  • Lemont, IL
  • NPI 1174149595
  Care Compare group NPD (past)
• DPT Holdings LLC

  • Occupational Therapist
  • Naperville, IL
  • NPI 1164020400
  Care Compare group
• DPT Holdings LLC

  • Occupational Therapist
  • Addison, IL
  • NPI 1427748136
  Care Compare group
• DPT Holdings LLC

  • Occupational Therapist
  • Lombard, IL
  • NPI 1912576208
  Care Compare group
• DPT Holdings LLC

  • Occupational Therapist
  • East Lansing, MI
  • NPI 1073136917
  Care Compare group
• DPT Holdings LLC

  • Occupational Therapist
  • Clarkston, MI
  • NPI 1073461083
  Care Compare group
• DPT Holdings LLC

  • Occupational Therapist
  • Kenosha, WI
  • NPI 1528671401
  Care Compare group
• DPT Holdings PLLC

  • Occupational Therapist
  • Brighton, MI
  • NPI 1821760927
  Care Compare group

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1104633197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD UNIT 206",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448711",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 EMERSON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013131",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFOWOROLA",
        "first_name": "AYODEJI",
        "middle_name": "K",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ko
• Jungyun Ko
• Mindy Sayo Kobara-Mates, PH.D., CCC-SP
• Omega Koch, DPT
• Judy Koenigsberg, PH.D.
• Alan D. Kogan, M.D.
• Ann E Kogen, L.C.S.W.
• Chau Ern Koh, DPT
• Eun-Kyu Koh, MD
• John Koh, PSY.D

• All providers in Evanston, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.