Active NPI
Olubunmi Victoria Ibitola, FNP
- Family Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F10200545
- Practice address
- 630 E 89TH St, Chicago, Il 60619
Chicago, IL 60619 - Phone
- (177) 371-9049
- Fax
- (844) 306-1653
- NPI assigned
- May 3, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F10200545 | IL | Primary |
Addresses
Primary practice location
630 E 89TH St, Chicago, Il 60619
Chicago, IL 60619
Mailing address
630 E 89TH St, Chicago, Il 60619
Chicago, IL 60619
Phone (177) 371-9049
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4815 S Western Blvd
Chicago, IL 60609-4067
Phone (630) 857-8311
611 Hunter LN
Lake Forest, IL 60045-4905
Phone (847) 615-2273
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F10200545 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Current | Accepting new patients | |
| Lifeline Physicians LLC | Current | Accepting new patients |
Locations
3601 S Harlem Ave
Berwyn, IL 60402
Phone (708) 484-1486
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
4815 S Western Blvd
Chicago, IL 60609
Phone (312) 380-1379
3450 Oakton St
Ste 300
Skokie, IL 60076
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Lake Forest, IL
- NPI 1841907839
-
- Internal Medicine Physician
- Skokie, IL
- NPI 1174013452
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Chicago, IL
- NPI 1043317746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774310400000",
"number": "1356086441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 E 89TH ST, CHICAGO, IL 60619",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60619",
"telephone_number": "177-371-9049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 E 89TH ST, CHICAGO, IL 60619",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60619",
"telephone_number": "177-371-9049",
"fax_number": "844-306-1653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBITOLA",
"first_name": "OLUBUNMI",
"middle_name": "VICTORIA",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-03",
"last_updated": "2026-03-24",
"certification_date": "2026-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "F10200545",
"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 Mar 24, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.