Individual provider Active NPI

Idayat Adeola Adekunle, FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1427415207
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209013710 Issued in IL
Practice address
1165 N Milwaukee Ave
Apt. 609
Chicago, IL 60642-4098
Phone
(773) 370-1539
Fax
(773) 377-6188
NPI assigned
Jan 25, 2016
Last updated
Jul 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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 209013710 IL Primary

Addresses

Primary practice location

1165 N Milwaukee Ave
Apt. 609
Chicago, IL 60642-4098

Mailing address

1165 N Milwaukee Ave
Apt. 609
Chicago, IL 60642-4098
Phone (773) 370-1539

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
I20160531000360 IL Practitioner - Nurse Practitioner 5294025565 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
71.53
Promoting interoperability
100
Improvement activities
40
Cost
76.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Perspective Behavioral and Pain Solutions LTD CurrentSince Oct 1, 2020 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
J C Medical Group LTD CurrentSince Feb 1, 2018 Accepting new patients
Mount Sinai Community Foundation CurrentSince Feb 7, 2018 Accepting new patients
Mount Sinai Community Foundation CurrentSince Feb 7, 2018 Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

6033 N Sheridan Rd
Ste N6
Chicago, IL 60660
Phone (773) 275-4800

2720 S River Rd
Ste 130
Des Plaines, IL 60018
Phone (224) 470-6107

2720 S River Rd
Ste 246
Des Plaines, IL 60018
Phone (847) 306-7277

1635 E 154th St
Dolton, IL 60419
Phone (708) 841-9550

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1427415207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 N MILWAUKEE AVE",
            "address_2": "APT. 609",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424098",
            "telephone_number": "773-370-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 N MILWAUKEE AVE",
            "address_2": "APT. 609",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424098",
            "telephone_number": "773-370-1539",
            "fax_number": "773-377-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKUNLE",
        "first_name": "IDAYAT",
        "middle_name": "ADEOLA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.