Oluyemi Samson Adeagbo

Key facts

NPI

1962371740

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

License

209.032399 (IL)

Practice address

1319 Butterfield Rd Ste 500
Downers Grove, IL 60515-5621

Phone

(414) 690-0069

NPI assigned

Oct 31, 2025

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

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.

• Orland Park Counselors PC Counselor · Orland Park, IL · NPI 1982361408
  Medicare reassignment Care Compare group NPD IL

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orland Park Counselors PC (2 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 31, 2025.

{
    "created_epoch": "1761868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1962371740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9345 KILREA DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621131",
            "telephone_number": "773-681-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 BUTTERFIELD RD STE 500",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155621",
            "telephone_number": "414-690-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEAGBO",
        "first_name": "OLUYEMI",
        "middle_name": "SAMSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-31",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.032399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Downers Grove, IL · Psychiatric/Mental Health Nurse Practitioner in Illinois