MEDICARE: SULAIMON KEHINDE OLADIPO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	1011663	IL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209034652	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558765164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SULAIMON KEHINDE OLADIPO

Provider Business Mailing Address
First Line	:	9415 S WESTERN AVE STE 206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-6700
Country	:	US
Telephone Number	:	773-301-8464
Fax Number	:	773-530-2643

Provider Business Practice Location Address
First Line	:	9415 S WESTERN AVE STE 206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-6700
Country	:	US
Telephone Number	:	773-301-8464
Fax Number	:	773-530-2643

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2014
Last Update Date	:	06/02/2026

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