Individual provider Active NPI

Felicia Abosede Olaifa, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynwood, IL
National Provider Identifier
1376346999
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209032046 Issued in IL
Practice address
20048 Preston LN
Lynwood, IL 60411-8663
Phone
(708) 270-9303
NPI assigned
Mar 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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 Practitioner 363LP0808X 209032046 IL Primary

Addresses

Primary practice location

20048 Preston LN
Lynwood, IL 60411-8663

Mailing address

20048 Preston LN
Lynwood, IL 60411-8663
Phone (708) 270-9303

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

State licenses

LicenseStateTypeSpecialty
209032046ILMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1376346999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20048 PRESTON LN",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604118663",
            "telephone_number": "708-270-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20048 PRESTON LN",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604118663",
            "telephone_number": "708-270-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAIFA",
        "first_name": "FELICIA",
        "middle_name": "ABOSEDE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209032046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; 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.