Individual provider Active NPI

Olubunmi Victoria Ibitola, FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1356086441
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10200545 Issued in IL
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

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516002324 IL Practitioner - Nurse Practitioner 0840656971 Reassigns benefits to 2 organizations

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
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians
Lifeline Physicians LLCGroup PAC ID 4082083811, 10 clinicians

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

LicenseStateTypeSpecialty
F10200545ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC CurrentSince Apr 4, 2023 Accepting new patients
Lifeline Physicians LLC CurrentSince Oct 1, 2025 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.