Individual provider Active NPI

Olabisi Oluwatoyin Oduola, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Crest Hill, IL
National Provider Identifier
1366359002
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209036486 Issued in IL
Practice address
2035 Manico CT
Crest Hill, IL 60403-0898
Phone
(331) 229-7341
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 209036486 IL Primary

Addresses

Primary practice location

2035 Manico CT
Crest Hill, IL 60403-0898

Mailing address

2035 Manico CT
Crest Hill, IL 60403-0898
Phone (331) 229-7341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1366359002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 MANICO CT",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030898",
            "telephone_number": "331-229-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 MANICO CT",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030898",
            "telephone_number": "331-229-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUOLA",
        "first_name": "OLABISI",
        "middle_name": "OLUWATOYIN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209036486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.