Anthony Olujimi, CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IL-10172-M Issued in IL

Practice address

15475 S Park Ave Ste 109
South Holland, IL 60473-1377

Phone

(708) 596-5680

Fax

(708) 596-5687

NPI assigned

Dec 7, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Ican Community Services Inc. NFP

  • Community/Behavioral Health Agency
  • South Holland, IL
  • NPI 1063702330
  NPD Authorized official
• Ican Community Services Inc. NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Holland, IL
  • NPI 1326544735
  NPD Authorized official
• Amazing Grace Healthcare Services

  • Nursing Care Agency
  • South Holland, IL
  • NPI 1861063091
  NPD

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1114432564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 109",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 109",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731377",
            "telephone_number": "708-596-5680",
            "fax_number": "708-596-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUJIMI",
        "first_name": "ANTHONY",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-07",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "IL-10172-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA52120001A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nse Ekpenyong, DDS, PC
• Alphecca May T. Octava, DC, MSAC
• Babatunde Isaac Ogunbiyi
• Lawrence Okafor, M.D.
• Alice Olujimi, RN CADC
• Omoba Luxury Transit LLC
• One Step at a Time, LTD
• Folarin Opakunle, DNP, FNP, PMHNP
• Optimum Health Chiropractic & Wellness Center, Inc.
• Opulent Luxury Laboratory (Opulent Lux Lab LLC.)

• Mental Health Counselor in South Holland, IL
• Providers in South Holland, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.