Mrs Modupe Olayinka Adefeso, PMHNP-BC in Evanston, IL

Mrs Modupe Olayinka Adefeso, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Evanston, Illinois. Her current practice location is 3347 Church St, Evanston, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 208-4457.

Mrs Modupe Olayinka Adefeso is licensed to practice in Illinois (license number 2022069013) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1134832512.

Contact Information

	Mrs Modupe Olayinka Adefeso, PMHNP-BC
	3347 Church St, Evanston, IL 60203-1722
	(847) 208-4457
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Modupe Olayinka Adefeso
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	3347 Church St, Evanston, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134832512
Provider Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023

Medicare PECOS Information:

PECOS PAC ID: 0446611347
Enrollment ID: I20230725001062

Medical Identifiers

Medical identifiers for Mrs Modupe Olayinka Adefeso such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134832512	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	2022069013 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Modupe Olayinka Adefeso allows following entities to bill medicare on her behalf.

Entity Name	J C Medical Group Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407961592 PECOS PAC ID: 4082668405 Enrollment ID: O20050309000350

Entity Name	Fabian Carbonell Md Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578767935 PECOS PAC ID: 7416980172 Enrollment ID: O20050913001117

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Modupe Olayinka Adefeso is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Modupe Olayinka Adefeso, PMHNP-BC 3347 Church St, Evanston, IL 60203-1722 Ph: (847) 208-4457	Mrs Modupe Olayinka Adefeso, PMHNP-BC 3347 Church St, Evanston, IL 60203-1722 Ph: (847) 208-4457

Reviews and Comments

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Mrs Modupe Olayinka Adefeso, PMHNP-BC - Medicare Nurse Practitioner in Evanston, IL