Individual provider Active NPI

Emmanuel Olaseyi Abidemi

  • Nurse's Aide
  • Chicago, IL
National Provider Identifier
1295489045
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
Practice address
4623 N Broadway St FL 2
Chicago, IL 60640-5011
Phone
(312) 498-0779
NPI assigned
Feb 10, 2022
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X NU
Homemaker 376J00000X NU
Nurse's Aide 376K00000X NU Primary

Addresses

Primary practice location

4623 N Broadway St FL 2
Chicago, IL 60640-5011

Mailing address

4623 N Broadway St FL 2
Chicago, IL 60640-5011
Phone (312) 498-0779

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Home Care Services Home Health Aide Current Accepting new patients

Locations

4623 N Broadway St
Fl 2
Chicago, IL 60640
Phone (312) 498-0779

Organizations & group practices 1

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1295489045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 N BROADWAY ST FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405011",
            "telephone_number": "312-498-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 N BROADWAY ST FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405011",
            "telephone_number": "312-498-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABIDEMI",
        "first_name": "EMMANUEL",
        "middle_name": "OLASEYI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "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 Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.