OLATUBOSUN ODUSI MD NPI 1972598084

NPI Information

NPI: 1972598084
Provider Name: OLATUBOSUN ODUSI, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3707 DOTY RD STE H
WOODSTOCK, IL
ZIP 60098
Phone: (815) 206-2800
Get Directions

Olatubosun Odusi, MD is a pediatrics in Woodstock, IL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Olatubosun Odusi, MD NPI is 1972598084. 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:

3707 DOTY RD STE H
WOODSTOCK, IL
ZIP 60098-530
Phone: (815) 206-2800
Fax: (815) 337-5491

The NPI 1972598084 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 9/14/2005 and was last updated on 3/14/2024.

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	208000000X	Pediatrics		216736	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1000006625	OTHER	NEW YORK	AFFINITY HEALTH
2	P2164401	OTHER	NEW YORK	OXFORD HEALTH PLAN
3	216736	OTHER	NEW YORK	HIP
4	2C9466	OTHER	NEW YORK	HEALTH NET
5	2031247	OTHER	NEW YORK	UNITED HEALTH CARE
6	7440270	OTHER	NEW YORK	AETNA PPO
7	2592835	OTHER	NEW YORK	AETNA USHC PPO
8	2697890	OTHER	NEW YORK	GHI
9	OO6736	OTHER	NEW YORK	ATLANTIS HEALTH PLAN
10	02112912	MEDICAID	NEW YORK
11	112940201	OTHER	NEW YORK	HEALTH PLUS
12	0100713-02	OTHER	NEW YORK	AMERICHOICE
13	1R0921	OTHER	NEW YORK	EMPIRE BCBS
14	216736-A15	OTHER	NEW YORK	HEALTH FIRST

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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