Individual provider Active NPI

Nimota Lawal

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1649140773
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.031511 Issued in IL
Practice address
2003 W Fulton St Ste 303
Chicago, IL 60612-2345
Phone
(312) 243-2223
Fax
(312) 243-2227
NPI assigned
Nov 5, 2025
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.031511 IL Primary

Addresses

Primary practice location

2003 W Fulton St Ste 303
Chicago, IL 60612-2345

Mailing address

1709 W Wallen Ave Apt 1I
Chicago, IL 60626-3986
Phone (773) 630-5596

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260129000846 IL Practitioner - Nurse Practitioner 7012495369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD @ Home Illinois, SCGroup PAC ID 7810167830, 53 clinicians

Practice addresses (Care Compare)

2003 W Fulton St
Suite 303
Chicago, IL 60612-2345
Phone (312) 243-2223

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.031511ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MD @ Home Illinois, SC CurrentSince Jan 26, 2026 Accepting new patients

Locations

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

Interoperability endpoints

  • Direct secure messaging: nimota.lawal.2@28492.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1649140773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 W WALLEN AVE APT 1I",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606263986",
            "telephone_number": "773-630-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122345",
            "telephone_number": "312-243-2223",
            "fax_number": "312-243-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWAL",
        "first_name": "NIMOTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-05",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.031511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.