Organization Active NPI

Abbot Healthcare Services LLC

  • Family Nurse Practitioner
  • Lynwood, IL
National Provider Identifier
1518658327
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ABBOT HEALTHCARE SERVICES LLC
Practice address
2933 198TH St
Lynwood, IL 60411-1478
Phone
(872) 316-1959
Fax
(708) 628-5386
NPI assigned
May 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Tolulope OlaniyanNPI 1538702022
Title
Managing Partner
Phone
(872) 316-1959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2933 198TH St
Lynwood, IL 60411-1478

Mailing address

2933 198TH St
Lynwood, IL 60411-1478
Phone (872) 316-1959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231017000382 IL Part B Supplier - Clinic/Group Practice 1456706068 Receives reassigned benefits from 2 practitioners
Practice locations: Lynwood, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1518658327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 198TH ST",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604111478",
            "telephone_number": "872-316-1959",
            "fax_number": "708-628-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 198TH ST",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604111478",
            "telephone_number": "872-316-1959",
            "fax_number": "708-628-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBOT HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "OLANIYAN",
        "authorized_official_first_name": "TOLULOPE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "872-316-1959"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "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 Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.