Active NPI
Simisola Odusanya, MD
- Anesthesiology Physician
- Chicago, IL
National Provider Identifier
1962146506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 125.084029
- Practice address
- 1740 W Taylor St
Chicago, IL 60612-7232 - Phone
- (713) 798-5900
- NPI assigned
- Apr 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 125.084029 | IL | Primary |
Addresses
Primary practice location
1740 W Taylor St
Chicago, IL 60612-7232
Mailing address
820 S Wood St Ste 100
Chicago, IL 60612-4325
Phone (312) 996-2933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.084029 | IL | MD | Anesthesiology Physician |
Interoperability endpoints
- sodusanya170955@uihealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1962146506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 S WOOD ST STE 100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124325",
"telephone_number": "312-996-2933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "713-798-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODUSANYA",
"first_name": "SIMISOLA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-20",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "125.084029",
"primary": true
}
],
"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 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.