DR. ADEYEMI OLUDARE FATOKI (NPI# 1760449938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760449938 |
| Entity Type | Individual |
| Full Name | DR. ADEYEMI OLUDARE FATOKI |
| Credential | M.D. |
| Practice Address |
315 E Mckinley Rd Ottawa IL 61350-4805 |
| Mailing Address |
1473 Ring Rd Calumet City IL 60409-5459 |
| Practice Telephone | 8154340228 |
| Practice Fax Number | 8154340148 |
| Mailing Telephone | 7088628156 |
| Mailing Fax Number | 7088628105 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2019-12-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 036084729 | IL | Allopathic & Osteopathic Physicians |
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
036084729 | IL | Allopathic & Osteopathic Physicians |
| N | 207QB0002X |
Family Medicine Specialization: Obesity Medicine |
036084729 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1473 Ring Rd, Calumet City, IL 604095459 | 7088628156 | 7088628105 |
| Street Address |
315 E MCKINLEY RD |
| City | OTTAWA |
| State | IL |
| Zip Code | 61350-4805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609303940 | Great Heights Medical Ltd. | Family Medicine | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2017-05-17 |
| 1881139418 | Great Heights Otp | Clinic/Center | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2017-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306336359 | Yulandist Jeannie Brown | Licensed Practical Nurse | 617 Columbus St, Ottawa, IL 61350 | 2018-05-15 |
| 1881071272 | Ashlee Herbold | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1718 N 2525th Rd, Ottawa, IL 61350 | 2015-05-05 |
| 1053702365 | Wanda Rohl | Social Worker | 3735 E 1453 Rd, Ottawa, IL 61350 | 2015-02-09 |
| 1538550868 | Erin Rose Boe | Physical Therapist | 2872 Columbus St, Unit 300, Ottawa, IL 61350 | 2015-02-09 |
| 1346572757 | Rebecca Samolitis | Counselor | 116 W Lafayette St, Suite 8, Ottawa, IL 61350 | 2010-02-10 |
| 1235383266 | Timothy I Miller O.d. P.C. | Optometrist | 107 E. Mckinley Rd., Ottawa, IL 61350 | 2008-11-04 |
| 1427204676 | Leo John Meagher | Counselor | 218 West Madison St, Ottawa, IL 61350 | 2008-08-07 |
| 1598938755 | Radiation Oncology of Northern Illinois LLC | Radiology | 1200 Starfire Dr, Ottawa, IL 61350 | 2008-04-09 |
| 1154538510 | Serenityonwheels, Inc. | Counselor | Serenity On Wheels, Inc. 630 Columbus Street, Ste # 214, Ottawa, IL 61350 | 2007-05-16 |
| 1205040904 | Dixie Devry | Occupational Therapist | 2532 Reynolds Manor, Ottawa, IL 61350 | 2007-05-10 |
| Find all providers in zip 61350 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609303940 | Great Heights Medical Ltd. | Family Medicine | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2017-05-17 |
| 1366541484 | Mark Andrews Mcvay | Family Medicine | 112 W Center St, Ottawa, IL 61350-3557 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609303320 | Brianne C Brown | Family Medicine | 1111 N Milwaukee Ave Unit 242, Vernon Hills, IL 60061-1658 | 2017-05-11 |
| 1649553892 | Physicians Community Medical Center North, S.c. | Family Medicine | 5320 159th St # 2n, Oak Forest, IL 60452-4705 | 2011-09-23 |
| 1538469739 | John Thomas Johns Jr. | Family Medicine | 210 N. Ashland, Chicago, IL 60607-1402 | 2010-10-22 |
| 1548447956 | Total Care Medical Clinic | Family Medicine | 6929 Ogden Ave, Berwyn, IL 60402-3649 | 2008-01-28 |
| 1205979028 | Gloria J Mouzon | Family Medicine | 140 N Ashland Ave, Chicago, IL 60607-1802 | 2007-02-14 |
| 1760448674 | Richard J Ready | Family Medicine | 999 Oakmont Plaza Dr Ste 100, Westmont, IL 60559-1381 | 2006-04-21 |
| 1841251378 | Britt Michael Borden | Family Medicine | 180 N Stetson Ave, Chicago, IL 60601-6710 | 2006-04-02 |
| 1992704381 | James Edward Beckett | Family Medicine | 326 W 64th St, St Bernard Hospital Dept Radiology, Chicago, IL 60621-3114 | 2005-07-18 |
| 1912519786 | Shark Addiction Treatment | Family Medicine | 1111 N Milwaukee Ave Unit 242, Vernon Hills, IL 60061-1658 | 2020-08-21 |
| 1831748573 | Recoveruscenters-carbondale LLC | Family Medicine | 2250 Reed Station Pkwy Ste 204, Carbondale, IL 62901-8104 | 2019-09-05 |
| Find all providers with the same taxonomy | ||||
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| 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.