Pearle Ao Olatunji

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209027043 Issued in IL

Practice address

1S218 Radford LN
Villa Park, IL 60181-3663

Phone

(773) 877-4652

NPI assigned

Jul 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Matters LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Villa Park, IL
  • NPI 1962337964
  NPD Authorized official

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1942933932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S218 RADFORD LN",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813663",
            "telephone_number": "773-877-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S218 RADFORD LN",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813663",
            "telephone_number": "773-877-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATUNJI",
        "first_name": "PEARLE",
        "middle_name": "AO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-06",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Nuter, CCC SLP
• Brittany Marie O'Brien
• Laurie O'Connell
• Anne O'Dowd
• Colleen Mary O'Leary, RN, AOCNS
• Marylu Ann Olsen
• Ernest S Opiola, DDS
• Joanna Maria Osos
• Christine Osterman
• Vanessa L Owens

• Nurse Practitioner in Villa Park, IL
• Providers in Villa Park, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.