Individual provider Active NPI

Kareem Tunde Obafaye

  • Non-emergency Medical Transport (VAN)
  • Des Plaines, IL
National Provider Identifier
1508674185
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
O11051877085 Issued in IL
Practice address
9021 Federal CT Apt 2D
Des Plaines, IL 60016-5045
Phone
(781) 363-8253
NPI assigned
Dec 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X O11051877085 IL Primary

Addresses

Primary practice location

9021 Federal CT Apt 2D
Des Plaines, IL 60016-5045

Mailing address

9021 Federal CT Apt 2D
Des Plaines, IL 60016-5045
Phone (781) 363-8253

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
O11051877085ILMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1508674185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 FEDERAL CT APT 2D",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165045",
            "telephone_number": "781-363-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 FEDERAL CT APT 2D",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165045",
            "telephone_number": "781-363-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBAFAYE",
        "first_name": "KAREEM",
        "middle_name": "TUNDE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": "O11051877085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.