Individual provider Active NPI

Olukemi Elizabeth Audu, PT

  • Physical Therapist
  • Skokie, IL
National Provider Identifier
1407561228
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070027190 Issued in IL
Practice address
9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703
Phone
(847) 983-8417
Fax
(888) 401-3644
NPI assigned
Jan 16, 2023
Last updated
Jan 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070027190 IL Primary

Addresses

Primary practice location

9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703

Mailing address

9933 Lawler Ave Ste 206B
Skokie, IL 60077-3703
Phone (847) 983-8417

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
070027190ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dependable Care Staffing, LLC Physical Therapist CurrentSince Jan 22, 2023 Accepting new patients

Locations

9933 Lawler Ave
Ste 206B
Skokie, IL 60077
Phone (847) 983-8417

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": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1407561228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 206B",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-983-8417",
            "fax_number": "888-401-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 206B",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-983-8417",
            "fax_number": "888-401-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDU",
        "first_name": "OLUKEMI",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.