Olumuyiwa Idowu, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-098784 Issued in IL

Practice address

840 W Irving Park Rd
Ste 204
Chicago, IL 60613-3011

Phone

(773) 871-5150

NPI assigned

Oct 4, 2006

Last updated

Dec 22, 2023By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal MedicineAlso: General Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Resilience Healthcare - Lakefront Medical Associates LLCGroup PAC ID 5991046468, 37 clinicians

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Thorek Memorial HospitalGroup PAC ID 4981593399, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thorek Memorial Hospital Hospital, Chicago, IL, CCN 140115
• Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
• Aperion Care Lakeshore Nursing home, Chicago, IL, CCN 145244
• Complete Care at Sheriden Commons Nursing home, Chicago, IL, CCN 145776
• Carlton at the Lake, the Nursing home, Chicago, IL, CCN 145679

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HGDCCA
• FHIR API: https://fhir4.healow.com/fhir/r4/HGDCCA/Endpoint/HGDCCA
• Direct secure messaging: olumuyiwa.idowu.1@18552.direct.athenahealth.com

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.

• Resilience Healthcare - Lakefront Medical Associates, LLC

  dba Chicago Health Medical Group

  • General Practice Physician
  • Chicago, IL
  • NPI 1205301926
  Medicare reassignment Care Compare group NPD
• Sheridan Medical Center, S.C

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568671691
  Medicare reassignment NPD Authorized official
• Thorek Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982643961
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Thorek Memorial Hospital

  dba Methodist Hospital of Chicago

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1891755351
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Woodland Hills, CA
  • NPI 1952333478
  NPD
• Southside Primary Care Group SC

  dba Metro Medical Associates

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1417403072
  NPD (past)

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

• Advocate North Side Health Network

  dba Advocate Illinois Masonic Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912014564
  Care Compare affiliation
• Beacon Care and Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1871163030

  Nursing home

  Care Compare affiliation
• Carlton Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1598136632

  Nursing home

  Care Compare affiliation
• Lakeshore Opco LLC

  dba Aperion Care Lakeshore

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1437738747

  Nursing home

  Care Compare affiliation
• Thorek Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982643961
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1538254511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "773-871-5150",
            "fax_number": "773-871-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD",
            "address_2": "STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "773-871-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU",
        "first_name": "OLUMUYIWA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-12-22",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-098784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098784",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Idia Wound & Pain Care LLC
• Ufuoma Chinenye Idjesa Sr.
• Alicia Elena Idler Perez, M.D.
• Mary Kaylle Idor
• Folashade Idowu
• Victoria Idowu
• Hakeem Idris, PHARMD
• Xavier Idriss, MD
• Idrivio LLC Dba Teamficient (TeamFicient)
• Marion Idzik, RPH

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.