Active NPI
Favour O Adebayo
- Physical Therapist
- Chicago, IL
National Provider Identifier
1245072081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1620 W Harrison St
Chicago, IL 60612-3801 - Phone
- (312) 942-5000
- NPI assigned
- Jun 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1620 W Harrison St
Chicago, IL 60612-3801
Mailing address
2951 S King Dr Apt 209
Chicago, IL 60616-3352
Phone (614) 684-8148
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718150400000",
"number": "1245072081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2951 S KING DR APT 209",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163352",
"telephone_number": "614-684-8148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 W HARRISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123801",
"telephone_number": "312-942-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEBAYO",
"first_name": "FAVOUR",
"middle_name": "O",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-12",
"last_updated": "2024-06-12",
"certification_date": "2024-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.