Bukola Jumoke Omotowon

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.031859 Issued in IL

Practice address

1741 Kayla LN Apt 3B
Waukegan, IL 60087-5805

Phone

(773) 983-8173

NPI assigned

Mar 10, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Careplus Psychiatric Services Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Nashville, TN
  • NPI 1215670294

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1710786264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 KAYLA LN APT 3B",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600875805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 KAYLA LN APT 3B",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600875805",
            "telephone_number": "773-983-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTOWON",
        "first_name": "BUKOLA",
        "middle_name": "JUMOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.031859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modupe Ogunyemi, M.S., CCC-SLP
• Francisco J Ojeda
• Ebele Okonkwor, CRNA
• Olutoyin Okunfolami, WHNP
• Stephanie Olivar
• One Hope United
• Debra L Oneil, RN
• Optimum Faith Lab Corp
• Optimum Faith Lab Corp
• Patricia Orellana

• Psychiatric/Mental Health Nurse Practitioner in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.