Individual provider Active NPI

Aderonke Beatrice Olaoye, MD

  • Student in an Organized Health Care Education/Training Program
  • Peoria, IL
National Provider Identifier
1164211330
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
125.085505 Issued in IL
Practice address
815 Main St
Peoria, IL 61602-1076
Phone
(309) 672-4986
NPI assigned
May 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125.085505 IL Primary

Addresses

Primary practice location

815 Main St
Peoria, IL 61602-1076

Mailing address

7030 N Stalworth Dr Apt 204
Peoria, IL 61615-9478
Phone (940) 595-8825

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227002131 IL Order and Referring Only - Family PracticePractitioner - Family Practice 7113408055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.085505ILMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: aolaoye445019@carlehiedirect.net

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1164211330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 N STALWORTH DR APT 204",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159478",
            "telephone_number": "940-595-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021076",
            "telephone_number": "309-672-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAOYE",
        "first_name": "ADERONKE",
        "middle_name": "BEATRICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.085505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.