Active NPI
Adeshalewa Ademoyo-Opakunle
- Family Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209006780
- 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, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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 100
- Quality
- 41.25
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 69.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209006780 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic Diagnostic of Illinois PLLC | Family | Current | Accepting new patients |
| In Home Medical Group LLC | Family | Current | Accepting new patients |
| New Horizon Residential Homes | Current | Accepting new patients | |
| Community Home Physicians, LLC | Current | 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.
-
- Physical Medicine & Rehabilitation Physician
- Oakbrook Terrace, IL
- NPI 1568909505
-
- Family Nurse Practitioner
- Rockford, IL
- NPI 1497087175
-
- Family Nurse Practitioner
- Mokena, IL
- NPI 1356485809
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Palatine, IL
- NPI 1568278141
-
- Physical Medicine & Rehabilitation Physician
- Charlotte, NC
- NPI 1750802344
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.