Theresa Olusola, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.027525 Issued in IL

Practice address

920 175TH St Ste 6
Homewood, IL 60430-2077

Phone

(708) 715-7440

Fax

(708) 365-2949

NPI assigned

May 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fabian Carbonell MD SCGroup PAC ID 7416980172, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Fabian Carbonell MD SC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1578767935
  Medicare reassignment Care Compare group NPD
• Psygenic Health Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Homewood, IL
  • NPI 1356152169
  Medicare reassignment Authorized official
• A1 Home Care Services LLC

  • In Home Supportive Care Agency
  • Homewood, IL
  • NPI 1679229736
  NPD Authorized official
• We Care Home Health Agency. LLC

  • Home Health Agency
  • Dyer, IN
  • NPI 1780044727
  NPD Authorized official
• We Care Home Health Agency. LLC

  • Home Health Agency
  • Dyer, IN
  • NPI 1821663030
  NPD Authorized official

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

• Presence Chicago Hospitals Network

  dba Presence Saint Joseph Hospital-Chicago

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1679659585
  Care Compare affiliation

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1447943154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 175TH ST STE 6",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302077",
            "telephone_number": "708-715-7440",
            "fax_number": "708-365-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 175TH ST STE 6",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302077",
            "telephone_number": "708-715-7440",
            "fax_number": "708-365-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSOLA",
        "first_name": "THERESA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.027525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micere Oden
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• Mary Osazuwa

• Psychiatric/Mental Health Nurse Practitioner in Homewood, IL
• Providers in Homewood, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.