MR. BAYO BABATUNDE AGBOLADE PMHNP-BC NPI 1780198192

NPI Information

NPI: 1780198192
Provider Name: MR. BAYO BABATUNDE AGBOLADE, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
4711 MIDLOTHIAN TPKE STE 14
CRESTWOOD, IL
ZIP 60418
Phone: (708) 743-2714
Get Directions

MR. Bayo Babatunde Agbolade, PMHNP-BC is a psychiatric/mental health nurse practitioner in Crestwood, IL. MR. Bayo Babatunde Agbolade, PMHNP-BC NPI is 1780198192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4711 MIDLOTHIAN TPKE STE 14
CRESTWOOD, IL
ZIP 60418-903
Phone: (708) 743-2714
Fax: (708) 251-8848

The NPI 1780198192 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/21/2017 and was last updated on 3/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	374U00000X	Home Health Aide				No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209.025433	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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