Kolawole Kayode Oyewole
Individual provider Active NPI Family Medicine Physician · Jacksonville, IL
NPI 1891180451 · NPPES record last updated Jul 21, 2026
Key facts
- NPI
- 1891180451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036.146853 (IL)
- Practice address
- 1600 W Walnut St
Jacksonville, IL 62650-1136 - Phone
- (217) 528-7541
- Fax
- (217) 606-3057
- NPI assigned
- Mar 31, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 26
Hospital & facility affiliations 3
Owned or controlled facilities with NPI records 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Springfield Clinic, LLP
Practice addresses (Care Compare)
775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300
800 E Carpenter St
Springfield, IL 62702-5324
Phone (217) 544-6464
Hospital & facility affiliations
- Memorial Medical Center
- St Johns Hospital
- Taylorville Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Springfield Clinic Lincoln Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2023 |
| Springfield Clinic Nokomis Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2023 |
| Springfield Clinic Raymond Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2023 |
| Springfield Clinic Neoga Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2023 |
| Springfield Clinic, LLP |
Rural health clinic | Limited Partnership Interest | Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180905000893 | IL | Practitioner - Family Practice |
4688970106 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.146853 | IL | MD | Family Medicine Physician |
| 12507724 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients | |
| Springfield Clinic LLP | Current | Accepting new patients | |
| Purewell Medical Clinic LLC | Family Medicine | Current |
Accepting new patients |
| Springfield Clinic, LLP | Current |
Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
1912 W 103rd St
Ste A
Chicago, IL 60643
Phone (773) 526-8121
29373 Network Pl
Chicago, IL 60673
100 W 162nd St
South Holland, IL 60473
Phone (708) 730-2200
1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275
775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300
Interoperability endpoints
- kolawoleoyewole@sfc.allscriptsdirect.net
- kolawole.oyewole.1@28977.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 036.146853 | IL | |
| Family Medicine Physician | 207Q00000X | 036.146853 | IL | Yes |
| Family Medicine Physician | 207Q00000X | 12507724 | IL |
Addresses
Primary practice location
1600 W Walnut St
Jacksonville, IL 62650-1136
Mailing address
PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541
Other practice location 1
2160 S 1st Ave
Maywood, IL 60153-3328
Phone (312) 945-4010
NPI Registry JSON
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1891180451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19248",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949248",
"telephone_number": "217-528-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W WALNUT ST",
"city": "JACKSONVILLE",
"state": "IL",
"postal_code": "626501136",
"telephone_number": "217-528-7541",
"fax_number": "217-606-3057"
}
],
"practiceLocations": [
{
"address_1": "2160 S 1st Ave",
"address_purpose": "LOCATION",
"city": "Maywood",
"state": "IL",
"postal_code": "601533328",
"country_code": "US",
"telephone_number": "312-945-4010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OYEWOLE",
"first_name": "KOLAWOLE",
"middle_name": "KAYODE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-31",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036.146853",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036.146853",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "12507724",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, IL
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- Hasan Farid Hasan Othman
- Overstreet Enterprises Inc
- Rodney E. Overstreet
- Sravanthi Pallapothu
- Park Place Center
- Passavant Memorial Area Hospital
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All providers in Jacksonville, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.