Illume Mental Health Group

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

ILLUME MENTAL HEALTH GROUP

Practice address

210 S Orange Grove Blvd
Pasadena, CA 91105-1705

Phone

(323) 300-4673

NPI assigned

Nov 11, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Adesewa Adelekun, MDNPI 1780189464

Title

Ceo

Phone

(323) 300-4673

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adesewa Eseosa Adelekun

  • Psychiatry Physician
  • Los Angeles, CA
  • NPI 1780189464
  NPD Authorized official

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1699599282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 S GRAND AVE APT 615",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154556",
            "telephone_number": "704-214-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S ORANGE GROVE BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911051705",
            "telephone_number": "323-300-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUME MENTAL HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "ADELEKUN",
        "authorized_official_first_name": "ADESEWA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-300-4673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Hanna Ibrahim, PHARM.D.
• Icare
• Shireen Michelle Iftikhar
• Reiko Lauren Ikemoto-Joseph, LMFT
• Raffi S Iknadossian, D.C.
• Illuminate Physical Therapy Inc
• Im Physical Therapy Inc
• David Songchan Im, D.P.T
• Kelly Im
• Imaging Specialist of Pasadena LLC

• Psychiatry Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.