Individual provider Active NPI

Tunji Ladipo, MD

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1245359025
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036-056167 Issued in IL
Practice address
45 W 111TH St
Chicago, IL 60628-4200
Phone
(773) 995-3000
NPI assigned
Mar 29, 2007
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-056167 IL
General Practice Physician 208D00000X 036-056167 IL Primary
Integrative Medicine Physician 202D00000X 36-056157 IL
Integrative Medicine Physician 202D00000X 036-056167 IL

Addresses

Primary practice location

45 W 111TH St
Chicago, IL 60628-4200

Mailing address

45 W 111TH St
Chicago, IL 60628-4200
Phone (773) 995-3195

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
I20060106000807 IL Practitioner - Internal MedicinePractitioner - Emergency Medicine 7315842812 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-056167ILMDIntegrative Medicine Physician
36-056157ILMDIntegrative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Rose Healthcare Management LLC Emergency Medicine CurrentSince Jan 1, 2021 Accepting new patients
Roseland Community Hospital Association General Practice CurrentSince Aug 19, 2022 Accepting new patients
Roseland Community Hospital Association CurrentSince Aug 19, 2022 Accepting new patients
Emergency Medical Specialists, II, S.C. Emergency Medicine CurrentSince Aug 14, 2002 Accepting new patients
Extended Care Specialist, LTD PastSince Jul 1, 2006 Accepting new patients
Ritl Medical Services SC Emergency Medicine PastSince Nov 28, 2009 Accepting new patients
Webster Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

7937 S Harlem Ave
Burbank, IL 60459

3435 W Van Buren St
Chicago, IL 60624
Phone (773) 265-7700

34816 Eagle Way
Chicago, IL 60678

45 W 111th St
Chicago, IL 60628
Phone (773) 995-3000

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1245359025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3195",
            "fax_number": "773-681-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADIPO",
        "first_name": "TUNJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-056167",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036-056167",
            "primary": true
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "IL",
            "license": "36-056157",
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "IL",
            "license": "036-056167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.