Impeccable Grace Services PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

IMPECCABLE GRACE SERVICES PLLC

Practice address

11724 S Justine St FL 1
Chicago, IL 60643-5028

Phone

(773) 419-0138

Fax

(619) 984-4174

NPI assigned

Sep 22, 2026

Organization subpart

No

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

Authorized official

Name

Mr. Olalekan Olumuyiwa Fasogbon, PMHNP-BCNPI 1487442158

Title

NP

Phone

(773) 419-0138

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olalekan Olumuyiwa Fasogbon, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1487442158
  Authorized official Same address or phone

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1598677502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11724 S JUSTINE ST FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606435028",
            "telephone_number": "773-419-0138",
            "fax_number": "619-984-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11724 S JUSTINE ST FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606435028",
            "telephone_number": "773-419-0138",
            "fax_number": "619-984-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPECCABLE GRACE SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "FASOGBON",
        "authorized_official_first_name": "OLALEKAN",
        "authorized_official_middle_name": "OLUMUYIWA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "773-419-0138",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, 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 Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.