Olumide Ayodeji Faniyan, MBBS, MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

125069281 Issued in IL

Practice address

1901 W Harrison St
Department of Pediatrics, Administration Building #1134
Chicago, IL 60612-3714

Phone

(312) 864-4505

NPI assigned

Jun 9, 2016

Sex

Male

Sole proprietor

No

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

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: ofaniyan1101855@direct.umm.edu

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1255780342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "address_2": "DEPARTMENT OF PEDIATRICS, ADMINISTRATION BUILDING #1134",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "address_2": "DEPARTMENT OF PEDIATRICS, ADMINISTRATION BUILDING #1134",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANIYAN",
        "first_name": "OLUMIDE",
        "middle_name": "AYODEJI",
        "name_prefix": "Dr.",
        "credential": "MBBS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125069281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qiao Fang, DDS
• Shirley Fang, RPH
• Tiffany Fang, LPC
• Vivienne Fang
• Zhe Amy Fang, M.D.
• Jessica M Fann
• Hayley Joy Fansler, MSN, APRN, FNP-C
• Sally R Fansler, P.T.
• Abra Leigh Fant, M.D.
• Colleen D Fant, MD, MPH

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.