Individual provider Active NPI

Adepeju Ojomalade

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1710597281
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021784 Issued in IL
Practice address
120 W 111TH St
Chicago, IL 60628-4215
Phone
(773) 768-5000
NPI assigned
Aug 8, 2020
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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 209021784 IL Primary

Addresses

Primary practice location

120 W 111TH St
Chicago, IL 60628-4215

Mailing address

120 W 111TH St
Chicago, IL 60628-4215
Phone (773) 449-5821

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
I20201208000638 IL Practitioner - Nurse Practitioner 4385056845 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209021784ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Medical Group, Inc. CurrentSince Nov 1, 2020 Accepting new patients

Locations

15255 S 94th Ave
Ste 500
Orland Park, IL 60462
Phone (708) 403-4055

Interoperability endpoints

  • Direct secure messaging: adepeju.ojomalade.1@18277.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/683/brand/4/csg/61/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1596844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1710597281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284215",
            "telephone_number": "773-449-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284215",
            "telephone_number": "773-768-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJOMALADE",
        "first_name": "ADEPEJU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-08",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.