Olubukola E Shodiya, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Evergreen Pk, Illinois. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Vitae Health Of Illinois Llc, Encounter Telehealth Inc and her current practice location is
8828 S Mozart Ave, Evergreen Pk, Illinois. You can reach out to her office (for appointments etc.) via phone at
(708) 996-9100.
Olubukola E Shodiya is licensed to practice in Illinois (license number 209.020728) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104456961.
Provider's Profile
| Full Name | Olubukola E Shodiya |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 8828 S Mozart Ave, Evergreen Pk, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Olubukola E Shodiya graduated from nursing school in 2019
NPI Data:
- NPI Number: 1104456961
- Provider Enumeration Date: 01/21/2020
- Last Update Date: 01/21/2020
Medicare PECOS Information:
- PECOS PAC ID: 9436574969
- Enrollment ID: I20200731000303
Medical Identifiers
Medical identifiers for Olubukola E Shodiya such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1104456961 | NPI | - | NPPES |
| 209.020728 | Other | IL | IDFPR |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209.020728 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Vitae Health Of Illinois Llc | 2365798410 | 149 |
| Encounter Telehealth Inc | 9931348307 | 21 |
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. Olubukola E Shodiya allows following entities to bill medicare on her behalf.
| Entity Name | Md Medical, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467754911
PECOS PAC ID: 5496938532
Enrollment ID: O20110325000846 |
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| Entity Name | Encounter Telehealth Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922342195
PECOS PAC ID: 9931348307
Enrollment ID: O20170407000860 |
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| Entity Name | Vitae Health Of Illinois Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174013452
PECOS PAC ID: 2365798410
Enrollment ID: O20180703002838 |
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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. Olubukola E Shodiya 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 |
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Olubukola E Shodiya,
8828 S Mozart Ave,
Evergreen Pk, IL 60805-1140
Ph: (708) 996-9100 | Olubukola E Shodiya,
8828 S Mozart Ave,
Evergreen Pk, IL 60805-1140
Ph: (708) 996-9100 |
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