NPIMap

Individual provider Active NPI

Tolulope Joshua Olu-Lawal, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1780207340
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036164693 Issued in IL
Practice address
1947 W Birchwood Ave Apt 3W
Chicago, IL 60626-1571
Phone
(312) 613-2940
NPI assigned
May 18, 2020
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036164693 IL Primary

Addresses

Primary practice location

1947 W Birchwood Ave Apt 3W
Chicago, IL 60626-1571

Mailing address

1947 W Birchwood Ave Apt 3W
Chicago, IL 60626-1571
Phone (312) 613-2940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630002460 IL Practitioner - Internal Medicine 4789043209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
Saint Anthony Medical CenterGroup PAC ID 5496654006, 45 clinicians

Practice addresses (Care Compare)

698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277

9951 Rock Cut Xing
Suite 200300
Loves Park, IL 61111-1999
Phone (815) 639-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036164693ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Anthony Medical Center CurrentSince May 15, 2023 Accepting new patients
Saint Anthony Medical Center CurrentSince May 15, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jun 25, 2023 Accepting new patients
Saint Anthony Medical Center Current Accepting new patients
Saint Anthony Medical Center Internal Medicine Past Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

698 Featherstone Rd
Rockford, IL 61107
Phone (815) 398-3277

698 Featherstone Rd
Ste 250
Rockford, IL 61107
Phone 81533994404

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1780207340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1947 W BIRCHWOOD AVE APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261571",
            "telephone_number": "312-613-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 W BIRCHWOOD AVE APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261571",
            "telephone_number": "312-613-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLU-LAWAL",
        "first_name": "TOLULOPE",
        "middle_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036164693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.