Individual provider Active NPI

Wasiu Durojaiye, P.A.

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1871706556
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001754 Issued in IL
Practice address
1276 N. Clybourn
Chicago, IL 60610
Phone
(312) 337-1073
Fax
(312) 337-7616
NPI assigned
May 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001754 IL Primary

Addresses

Primary practice location

1276 N. Clybourn
Chicago, IL 60610

Mailing address

1276 N. Clybourn
Chicago, IL 60610
Phone (312) 337-1073

Other identifiers 1

IdentifierTypeStateIssuer
085001754OtherILLICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140422001198 IL Practitioner - Physician Assistant 4688620198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone (312) 337-1073

4259 S Berkeley Ave
Chicago, IL 60653-3030
Phone (773) 268-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Near North Health Service Corporation Current Accepting new patients

Locations

1276 N Clybourn Ave
Chicago, IL 60610
Phone (312) 337-1073

150 E Huron St
Chicago, IL 60611
Phone (312) 640-2473

1520 N Kostner Ave
Chicago, IL 60651
Phone (312) 216-8020

4259 S Berkeley Ave
Chicago, IL 60653
Phone (773) 268-7600

800 N Kedzie Ave
Chicago, IL 60651
Phone (773) 722-8202

Interoperability endpoints

  • Direct secure messaging: wasiu.durojaiye.1@31131.direct.athenahealth.com

Organizations & group practices 1

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 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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871706556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 N. CLYBOURN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60610",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 N. CLYBOURN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60610",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROJAIYE",
        "first_name": "WASIU",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "085001754",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.