DR. OMOTOLA WASILAT DANMOLE-ODIMAYO


Address: 5850 6th Street Frontage Rd E Ste A, Springfield, IL 62703-5194
Phone: 2175295046

DR. OMOTOLA WASILAT DANMOLE-ODIMAYO (NPI# 1619179041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619179041
Entity Type Individual
Full Name DR. OMOTOLA WASILAT DANMOLE-ODIMAYO
Credential FNP-BC, DNP
Practice Address 5850 6th Street Frontage Rd E Ste A
Springfield
IL 62703-5194
Mailing Address 7011 Preston Dr
Springfield
IL 62711-4310
Practice Telephone 2175295046
Practice Fax Number 2175296154
Mailing Telephone 2175530266
Enumeration Date 2007-06-05
Last Update Date 2019-02-07
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WP0808X Registered Nurse
Specialization: Psych/Mental Health
041-306705 IL Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
209.006961 IL Physician Assistants & Advanced Practice Nursing Providers
N 364SF0001X Clinical Nurse Specialist
Specialization: Family Health
209.006961 IL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
7011 Preston Dr, Springfield, IL 627114310 2175530266

Office Location

Street Address 5850 6TH STREET FRONTAGE RD E STE A
City SPRINGFIELD
State IL
Zip Code 62703-5194

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497391304 Kathy Jo Sharp Nurse Practitioner 5850 6th Street Frontage Rd E Ste A, Springfield, IL 62703-5194 2019-11-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790260917 Jessica Lynne Zeeck Behavior Technician 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 2018-10-03
1215415799 Bree Schmulbach Nurse Practitioner Bsb Room 20, Springfield, IL 62703 2018-08-06
1144712100 Fresenius Medical Care Springfield East, LLC Clinic/Center 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 2018-06-05
1558889170 Ji Woung Choi Dentist 687 E Linton Ave., Springfield, IL 62703 2017-09-04
1477006161 Encompass Home Health of The Midwest,llc Home Health 2970 Baker Dr, Springfield, IL 62703 2016-07-28
1851706824 Terah Louise Holland Obstetrics & Gynecology 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 2014-06-27
1578993101 Corey Moore Behavioral Analyst 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 2013-11-18
1134463052 The Center for Youth and Family Solutions Inc. Voluntary or Charitable 614 North Sixth Street, Springfield, IL 62703 2012-11-15
1447519111 Tenshi Furumi Specialist/Technologist One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 2012-05-15
1447558390 Shalini Mulkanoor Family Medicine 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 2011-03-02
Find all providers in zip 62703

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669072823 Rachel Westbrook Nurse Practitioner 1417 Burning Bush Ct, Springfield, IL 62712-7529 2020-10-27
1730786377 Catherine Newman Nurse Practitioner 27124 La-42, Springfield, LA 70462 2020-10-07
1275146268 Courtney Wilbern Nurse Practitioner 1200 W Centre St, Springfield, IL 62704-5812 2020-08-28
1588276240 Andrew Ronald Mouser Nurse Practitioner 607 Prospect Rd, Springfield, PA 19064-2819 2020-08-23
1821609082 William Coleman Bryant Nurse Practitioner 5552 W Longleaf Dr, Springfield, MO 65802-7834 2020-08-12
1386254399 Ashley Lynn Murray Nurse Practitioner 2443 E Greenwood St, Springfield, MO 65804-3907 2020-08-04
1679182281 Erica Gail Hunt Nurse Practitioner 2813 Haverford Rd, Springfield, IL 62704-4267 2020-07-29
1063020063 Gage Azeez Nurse Practitioner 46 Timber Ln, Springfield, MA 01119-2828 2020-07-16
1033737440 Janne L Nicholson Nurse Practitioner 8360 Dunham Ct Apt G, Springfield, VA 22152-1122 2020-07-13
1922623156 Amanda E Hildebrand Nurse Practitioner 3370 Carman Ave, Springfield, IL 62703-4642 2020-06-12
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Competitor

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City SPRINGFIELD
Zip Code 62703

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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