Individual provider Active NPI

Olufunke Grace Ajifolokun

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1922600873
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.003940 Issued in IL
Practice address
850 W 63Rd St
Chicago, IL 60621-1902
Phone
(773) 377-7304
NPI assigned
Nov 14, 2020
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209024875 IL
Family Nurse Practitioner 363LF0000X 277.003940 IL Primary
Family Nurse Practitioner 363LF0000X 209024875 IL
Registered Nurse 163W00000X 041427005 IL
Emergency Registered Nurse 163WE0003X 041427005 IL

Addresses

Primary practice location

850 W 63Rd St
Chicago, IL 60621-1902

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 352-1515

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
I20220502001538 IL Practitioner - Nurse Practitioner 7315334893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

4848 W Irving Park Rd
Chicago, IL 60641-2718
Phone (855) 625-7878

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041427005ILMDRegistered Nurse
209024875ILMDFamily Nurse Practitioner
277.003940ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Nurse Practitioner CurrentSince Feb 5, 2024 Accepting new patients
Conscientious Incorporated Family CurrentSince Apr 7, 2025 Accepting new patients

Locations

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

850 W 63rd St
Chicago, IL 60621
Phone (773) 377-7304

17045 Westview Ave
South Holland, IL 60473
Phone (708) 527-8371

Organizations & group practices 2

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 3

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": "1605312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1922600873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211902",
            "telephone_number": "773-377-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJIFOLOKUN",
        "first_name": "OLUFUNKE",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-14",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024875",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.003940",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024875",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041427005",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IL",
            "license": "041427005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.