Individual provider Active NPI

Lanre B Olanrewaju

  • Psychiatric/Mental Health Nurse Practitioner
  • Danville, IL
National Provider Identifier
1154945798
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71014738A Issued in IN
Practice address
1900 E Main St
Danville, IL 61832-5100
Phone
(217) 554-3000
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71014738A IN Primary

Addresses

Primary practice location

1900 E Main St
Danville, IL 61832-5100

Mailing address

1900 E Main St
Danville, IL 61832-5100

Other practice location 1

4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone (804) 605-9263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250630004021 IN Practitioner - Nurse Practitioner 0648783944 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71014738AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sycamore Springs Physician Group LLC CurrentSince Dec 8, 2025 Accepting new patients
Mindglow Mental Healthcare LLC Psychiatric/Mental Health CurrentSince May 17, 2025 Accepting new patients
Sondermind Provider Network LLC Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients

Locations

610 N High School Rd
Ste B
Indianapolis, IN 46214
Phone (317) 223-5648

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

833 Park East Blvd
Lafayette, IN 47905
Phone (765) 441-3168

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1154945798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100",
            "telephone_number": "217-554-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 S Lancaster Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752167167",
            "country_code": "US",
            "telephone_number": "804-605-9263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLANREWAJU",
        "first_name": "LANRE",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71014738A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.