Active NPI
Osamudiame Magdalene Olawoore, PHAMD
- Pharmacist
- Dixon, IL
National Provider Identifier
1184410813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051305992
- Practice address
- 1640 S Galena Ave
Dixon, IL 61021-9611 - Phone
- (815) 288-7770
- NPI assigned
- Apr 18, 2025
- Last updated
- Apr 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051305992 | IL | Primary |
Addresses
Primary practice location
1640 S Galena Ave
Dixon, IL 61021-9611
Mailing address
1913 Golden Gate LN
Naperville, IL 60563-1457
Phone (847) 477-1396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051305992 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1184410813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1913 GOLDEN GATE LN",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605631457",
"telephone_number": "847-477-1396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 S GALENA AVE",
"city": "DIXON",
"state": "IL",
"postal_code": "610219611",
"telephone_number": "815-288-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAWOORE",
"first_name": "OSAMUDIAME",
"middle_name": "MAGDALENE",
"credential": "PHAMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-18",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051305992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dixon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.