Individual provider Active NPI

Ekiomoado Agnes Olumese, MD

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1871283531
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036179644 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 702-1000
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036179644 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

1136 S Delano CT W Apt 303
Chicago, IL 60605-3734
Phone (301) 275-7950

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714001508 IL Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 6608236245

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Vanderbilt University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5965

Hospital & facility affiliations

  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

National Provider Directory

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

Hospital & facility affiliations 1

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1871283531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 S DELANO CT W APT 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053734",
            "telephone_number": "301-275-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUMESE",
        "first_name": "EKIOMOADO",
        "middle_name": "AGNES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036179644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.