Omotola Kehinde Ajibade

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036167010 Issued in IL

Practice address

2160 S 1St Ave
Maywood, IL 60153-3328

Phone

(708) 216-9000

NPI assigned

Sep 2, 2011

Last updated

Aug 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, NJ, IL, WI4 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

Psychiatry

Education

Mercer University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians

SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

Specialty Physicians of Illinois LLCGroup PAC ID 4183529456, 114 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
• Direct secure messaging: oajibade37088@cghmc.direct-ci.com
• Direct secure messaging: oajibade493318@direct-ehr-ssmhc.com
• Direct secure messaging: omotola.ajibademd.p1@direct.cfg.nextgenshare.com

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.

• Specialty Physicians of Illinois, LLC

  • Internal Medicine Physician
  • Greenwood, IN
  • NPI 1124075676

  IL

  Medicare reassignment Care Compare group NPD
• SSM Health Care St Louis

  dba SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment Care Compare group NPD
• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801
  Medicare reassignment Care Compare group
• Blessing Hospital

  • Multi-Specialty Clinic/Center
  • Quincy, IL
  • NPI 1114471737
  Medicare reassignment NPD
• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Medicare reassignment NPD
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment NPD
• St. Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196
  Medicare reassignment NPD
• Agnesian Healthcare, Inc

  dba SSM Health St Agnes Hospital Fond Du Lac

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Medicare reassignment NPD
• SSM Health Care of Wisconsin Inc

  • Internal Medicine Physician
  • Baraboo, WI
  • NPI 1730160011
  Medicare reassignment NPD
• The Monroe Clinic, Inc.

  dba SSM Health Monroe Clinic Medical Group

  • Specialist
  • Monroe, WI
  • NPI 1386720548
  Medicare reassignment NPD
• Center for Family Guidance, PC

  • Geriatric Psychiatry Physician
  • Marlton, NJ
  • NPI 1508803388
  Medicare reassignment
• Blessing Hospital

  dba Blessing Hospital Social Workers

  • Social Worker
  • Quincy, IL
  • NPI 1073918462
  NPD

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1841571841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 HOWELL MILL RD NW FL 8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185557",
            "telephone_number": "678-470-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012834",
            "country_code": "US",
            "telephone_number": "217-223-8400",
            "fax_number": "217-224-9383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 Howell Mill Rd NW Fl 8",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303185557",
            "country_code": "US",
            "telephone_number": "678-470-1562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012719",
            "country_code": "US",
            "telephone_number": "217-224-4453",
            "fax_number": "217-224-9383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJIBADE",
        "first_name": "OMOTOLA",
        "middle_name": "KEHINDE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-02",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036167010",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA11363300",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "94515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oajibade34327@blessing.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1005 Broadway St",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623012834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yunus Shajee Ahmed, DO
• Dinkar Ahuja, MD
• Angela Ai, MD
• Julia Aid
• Saleh Aiyash, MD
• Olanrewaju Oluwashina Akande, MD
• Gulnihal Akbulut
• Malek Akhal, MD
• Virina Akhnoukh
• Fatima Alzahraa Akili, M.D.

• Psychiatry Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.