Olushola Shobowale, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.029789 Issued in IL

Practice address

4580 Weaver Pkwy Ste 102
Warrenville, IL 60555-3864

Phone

(651) 208-4176

NPI assigned

Jun 28, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1245075506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 WEAVER PKWY STE 102",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553864",
            "telephone_number": "651-208-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 WEAVER PKWY STE 102",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553864",
            "telephone_number": "651-208-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOBOWALE",
        "first_name": "OLUSHOLA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.029789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanit U Shah
• Safeya Shah, OT
• Olesia Shalayska
• Lauren Elizabeth Sheehy, AGCNS
• Jaclyn Sheldon
• Jeremy Shoup
• John F Showalter, MD
• Kristin A Siebert, PT
• Tatiana Sifri, MA, LCPC, NCC
• Navdeep Singh

• Psychiatric/Mental Health Nurse Practitioner in Warrenville, IL
• Providers in Warrenville, 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 Jun 28, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.