Olajumoke Elizabeth Adekoya, NURSE PRACTITIONER
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Chicago, IL
NPI 1699360289 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1699360289
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 209022776 (IL)
- Practice address
- 1406 E 68TH St Apt 3
Chicago, IL 60637-6235 - Phone
- (773) 782-7609
- NPI assigned
- Mar 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Beth Psychiatry LLC
Practice addresses (Care Compare)
20855 S Lagrange Rd
Suite 205
Frankfort, IL 60423-2043
Phone (773) 782-7609
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211014000523 | IN | Practitioner - Nurse Practitioner | 1153729645 | Reassigns benefits to 1 organization |
| I20211109001320 | IL | Practitioner - Nurse Practitioner | 1153729645 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71011593A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paragon Clinical LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Beth Psychiatry LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Beth Psychiatry LLC | Current |
Accepting new patients | |
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current |
Accepting new patients |
| Community Care Network Inc | Current |
Accepting new patients | |
| Success TMS Professional Services, PLLC | Current |
Accepting new patients | |
| Paragon Clinical Midwest, LLC | Past | Accepting new patients |
Locations
1615 S Congress Ave
Ste 200
Delray Beach, FL 33445
1000 Brickell Ave
Ste 715
Miami, FL 33131
Phone (786) 791-3080
1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706
4753 N Broadway St
Ste 1025
Chicago, IL 60640
Phone (312) 796-9174
605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338
1131 W Lawrence Ave
Chicago, IL 60640
1131 W Lawrence Ave
Chicago, IL 60640
Phone (312) 361-8459
20855 S La Grange Rd
Ste 205
Frankfort, IL 60423
Phone (773) 782-7609
15 Spinning Wheel Rd
Ste 212
Hinsdale, IL 60521
Phone (561) 870-9158
4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700
8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084
9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166
13740 N Highway 183
Ste L2
Austin, TX 78750
Phone (512) 710-7644
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71011593A | IN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209022776 | IL | Yes |
Addresses
Primary practice location
1406 E 68TH St Apt 3
Chicago, IL 60637-6235
Mailing address
1406 E 68TH St Apt 3
Chicago, IL 60637-6235
Phone (773) 782-7609
Other names
- Olajumoke Adewale
Other providers in Chicago, IL
- Adekonla Tolulope Adegunsoye
- Ayodeji Adegunsoye
- Bahirat Adeola Adejare
- Ademola Jimoh Adekola Jr.
- Kehinde Adekola
- Semat Adekoya
- Shardae Adekoya
- Idayat Adeola Adekunle
- Alaba Adelakun
- Catherine Olufunso Adelakun
All providers in Chicago, IL · Psychiatric/Mental Health Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.