Idayatu Ola Omoniyi, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209024507 Issued in IL

Practice address

7060 Centennial Dr Ste 102B
Tinley Park, IL 60477-1699

Phone

(708) 575-8043

Fax

(708) 575-7872

NPI assigned

Dec 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Idayatu Ola Omoniyi Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/thrivecc/r4/

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.

• Victory Mental Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tinley Park, IL
  • NPI 1629870506

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Christian Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1790888238

  Multi-Specialty

  Medicare reassignment NPD
• Hamdard Health Alliance

  • Federally Qualified Health Center (FQHC)
  • Addison, IL
  • NPI 1609875053

  Multi-Specialty

  Medicare reassignment NPD
• Thriveworks Telepsychiatry - Illinois

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1154099620

  Multi-Specialty

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IL, Multi-Specialty

  Medicare reassignment NPD
• Christian Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lansing, IL
  • NPI 1750619680
  NPD
• Hamdard Health Alliance

  • Federally Qualified Health Center (FQHC)
  • Bensenville, IL
  • NPI 1700470580
  NPD
• Thrive Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park, IL
  • NPI 1467586669

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1174282826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7060 CENTENNIAL DR STE 102B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771699",
            "telephone_number": "708-575-8043",
            "fax_number": "708-575-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7060 CENTENNIAL DR STE 102B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771699",
            "telephone_number": "708-575-8043",
            "fax_number": "708-575-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMONIYI",
        "first_name": "IDAYATU",
        "middle_name": "OLA",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209024507",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.024507",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277003719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IDAYATU",
            "last_name": "OMONIYI",
            "middle_name": "OLA",
            "credential": "PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Open Advanced MRI of Tinley Park, LLC

• Psychiatric/Mental Health Nurse Practitioner in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.