Theresa Olusola, PMHNP in Homewood, IL - Medicare Nurse Practitioner

Theresa Olusola, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Homewood, Illinois. Her current practice location is 900 Ridge Rd Ste 2m, Homewood, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 715-7440.

Theresa Olusola is licensed to practice in Illinois (license number 209.027525) 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 1447943154.

Contact Information

	Theresa Olusola, PMHNP
	900 Ridge Rd Ste 2m, Homewood, IL 60430-1933
	(708) 715-7440
	(708) 365-2949

Map and Direction

Provider's Profile

Full Name	Theresa Olusola
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	900 Ridge Rd Ste 2m, Homewood, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447943154
Provider Enumeration Date: 05/30/2023
Last Update Date: 05/30/2023

Medicare PECOS Information:

PECOS PAC ID: 2769768035
Enrollment ID: I20231121003285

Medical Identifiers

Medical identifiers for Theresa Olusola such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447943154	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	209.027525 (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. Theresa Olusola allows following entities to bill medicare on her behalf.

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. Theresa Olusola 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
Theresa Olusola, PMHNP 1416 Westridge Dr, Dyer, IN 46311-1899 Ph: (708) 715-7440	Theresa Olusola, PMHNP 900 Ridge Rd Ste 2m, Homewood, IL 60430-1933 Ph: (708) 715-7440

Reviews and Comments

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Theresa Olusola, PMHNP - Medicare Nurse Practitioner in Homewood, IL