Individual provider Active NPI

Adeshalewa Ademoyo-Opakunle

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1891983524
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209006780 Issued in IL
Practice address
840 W Irving Park Rd
Ste 301
Chicago, IL 60613-3011
Phone
(773) 975-3269
Fax
(773) 975-3270
NPI assigned
Oct 9, 2007
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209006780 IL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209006780 IL

Addresses

Primary practice location

840 W Irving Park Rd
Ste 301
Chicago, IL 60613-3011

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 491-1426

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
I20071128000432 IL Practitioner - Nurse Practitioner 2365531357 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Home Physicians LLCGroup PAC ID 4981988771, 81 clinicians

Practice addresses (Care Compare)

1 S450 Summit Ave
Suite 165
Oakbrook Terrace, IL 60181-3952
Phone (630) 320-6871

Merit-based Incentive Payment System (MIPS)

Final score
58.33 of 100Reported as group
Quality
41.25
Promoting interoperability
0
Improvement activities
40
Cost
69.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209006780ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince Sep 29, 2007 Accepting new patients
In Home Medical Group LLC Family CurrentSince Aug 28, 2017 Accepting new patients
New Horizon Residential Homes Current Accepting new patients
Community Home Physicians, LLC CurrentSince Jan 15, 2025 Accepting new patients
The SNF Group, PLLC Past Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

1S450 Summit Ave
Ste 165
Oakbrook Terrace, IL 60181
Phone (630) 320-6871

4215 Newburg Rd
Rockford, IL 61108
Phone (815) 988-8500

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1891983524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-491-1426",
            "fax_number": "812-492-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD",
            "address_2": "STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "773-975-3269",
            "fax_number": "773-975-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEMOYO-OPAKUNLE",
        "first_name": "ADESHALEWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006780",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209006780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.