Individual provider Active NPI

Sulaimon Kehinde Oladipo

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1558765164
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209034652 Issued in IL
Practice address
9415 S Western Ave Ste 206
Chicago, IL 60643-6700
Phone
(773) 301-8464
Fax
(773) 530-2643
NPI assigned
Oct 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 1011663 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209034652 IL Primary

Addresses

Primary practice location

9415 S Western Ave Ste 206
Chicago, IL 60643-6700

Mailing address

9415 S Western Ave Ste 206
Chicago, IL 60643-6700
Phone (773) 301-8464

Other identifiers 1

IdentifierTypeStateIssuer
1011663MedicaidIL

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
1011663ILMDHome Health Registered Nurse
209034652ILMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1558765164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 S WESTERN AVE STE 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606436700",
            "telephone_number": "773-301-8464",
            "fax_number": "773-530-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 S WESTERN AVE STE 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606436700",
            "telephone_number": "773-301-8464",
            "fax_number": "773-530-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLADIPO",
        "first_name": "SULAIMON",
        "middle_name": "KEHINDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "1011663",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209034652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011663",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.