Adeyemi Oludare Fatoki, M.D.

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

60259-20 Issued in WI

Practice address

315 E McKinley Rd
Ottawa, IL 61350-4805

Phone

(815) 434-0228

Fax

(815) 434-0148

NPI assigned

Apr 28, 2006

Last updated

Sep 23, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI, IN, AZ4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Addiction MedicineAlso: Preventive Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 36)

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.

• Great Heights Medical LTD.

  • Addiction Medicine (Preventive Medicine) Physician
  • Ottawa, IL
  • NPI 1609303940
  Medicare reassignment NPD Authorized official
• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment Care Compare group NPD
• Cleanslate Medical Group of Arizona PLLC

  dba Cleanslate Centers- North 40th Phoenix, AZ.

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1801421656
  Medicare reassignment NPD
• Cleanslate Medical Group of Wisconsin, SC

  • Addiction Medicine (Internal Medicine) Physician
  • Glendale, WI
  • NPI 1518404854
  Medicare reassignment NPD
• Great Heights Otp

  • Methadone Clinic
  • Calumet City, IL
  • NPI 1720516099
  NPD Authorized official
• Great Heights Family Medicine LTD.

  • Addiction Medicine (Family Medicine) Physician
  • Calumet City, IL
  • NPI 1285854067
  Authorized official Same address or phone
• Great Heights Otp

  dba Great Heights OTP Ottawa

  • Methadone Clinic
  • Ottawa, IL
  • NPI 1881139418
  Authorized official Same address or phone
• Hansers Associates

  • Family Medicine Physician
  • Calumet City, IL
  • NPI 1356339790
  Authorized official Same address or phone
• Cleanslate Medical Group of Arizona PLLC

  dba CleanSlate Centers- West Thomas Phoenix, AZ

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1245865096
  NPD
• Cleanslate Medical Group of Arizona PLLC

  dba Cleanslate Centers- Gilbert, AZ.

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1376178129
  NPD
• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)
• Total Wellness Centers, LLC

  dba Cleanslate Centers

  • Clinical Medical Laboratory
  • Holyoke, MA
  • NPI 1770020018
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1760449938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1473 RING RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095459",
            "telephone_number": "708-862-8156",
            "fax_number": "708-862-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E MCKINLEY RD",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613504805",
            "telephone_number": "815-434-0228",
            "fax_number": "815-434-0148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1473 Ring Rd",
            "address_purpose": "LOCATION",
            "city": "Calumet City",
            "state": "IL",
            "postal_code": "604095459",
            "country_code": "US",
            "telephone_number": "708-862-8156",
            "fax_number": "708-862-8105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20611 Watertown Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531861871",
            "country_code": "US",
            "telephone_number": "262-901-4450",
            "fax_number": "262-901-4451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021403",
            "country_code": "US",
            "telephone_number": "317-396-2676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8410 W Thomas Rd Ste 124",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373373",
            "country_code": "US",
            "telephone_number": "480-417-5289",
            "fax_number": "602-812-7491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATOKI",
        "first_name": "ADEYEMI",
        "middle_name": "OLUDARE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "60259-20",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01062968A",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "AZ",
            "license": "64981",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036084729",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "WI",
            "license": "60259-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Emmert, O.D.
• Empowering Minds Counseling, PLLC (EMC Ottawa)
• Eyesite-Illinois Valley, L.L.C.
• Jonathan Edward Faber, DMD
• Daniel Patrick Farrell, D.C.
• Benjamin D Fightmaster
• Carrie B Finley, APN, CNP
• Ashley Fiscal
• Colleen M Fitzpatrick-Grabow, LMT
• Whitney Nicole Flach, LPC

• Addiction Medicine (Preventive Medicine) Physician in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Addiction Medicine (Preventive Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.