Active NPI
Gabriel Oluwakotanmi, CNS
- Clinical Nurse Specialist
- Chicago, IL
National Provider Identifier
1245615947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 209.011501
- Practice address
- 8056 S Harper Ave
Chicago, IL 60619-4637 - Phone
- (773) 443-6307
- NPI assigned
- Jul 23, 2015
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 209.011501 | IL | Primary |
Addresses
Primary practice location
8056 S Harper Ave
Chicago, IL 60619-4637
Mailing address
8056 South Harper Avenue
Chicago, IL 60619
UM
Phone (773) 443-6307
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
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.011501 | IL | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1245615947",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "8056 SOUTH HARPER AVENUE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60619",
"telephone_number": "773-443-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8056 S HARPER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606194637",
"telephone_number": "773-443-6307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUWAKOTANMI",
"first_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "CNS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-23",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "IL",
"license": "209.011501",
"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 Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.