Active NPI
Jesutomilola Oluwanifesi Olayemi, MD
- Psychiatry Physician
- Springfield, IL
National Provider Identifier
1619712361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 125084282
- Practice address
- 701 N 1St St
Springfield, IL 62781-0001 - Phone
- (217) 788-3000
- NPI assigned
- Jun 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 125084282 | IL | Primary |
Addresses
Primary practice location
701 N 1St St
Springfield, IL 62781-0001
Mailing address
319 E Madison St FL 3
Springfield, IL 62701-1035
Phone (217) 545-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240718001396 | IL | Order and Referring Only - Psychiatry | 4082150719 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1619712361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 E MADISON ST FL 3",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011035",
"telephone_number": "217-545-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N 1ST ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627810001",
"telephone_number": "217-788-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAYEMI",
"first_name": "JESUTOMILOLA",
"middle_name": "OLUWANIFESI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-26",
"last_updated": "2024-06-26",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "125084282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.