Healthcare Provider Details

I. General information

NPI: 1770038192
Provider Name (Legal Business Name): IDAYATU OLAOYE R.N., BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3612 LINCOLN HWY STE 19
OLYMPIA FIELDS IL
60461-1637
US

IV. Provider business mailing address

232 W 14TH ST
CHICAGO HEIGHTS IL
60411-2537
US

V. Phone/Fax

Practice location:
  • Phone: 708-612-1144
  • Fax:
Mailing address:
  • Phone: 708-612-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number4000526
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3001392
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704349300
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: