Bukola Jumoke Omotowon
NPI 1710786264ActiveIndividual· Nurse Practitioner, Psych/Mental Health· Waukegan, IL
Nurse Practitioner, Psych/Mental Health in Waukegan, Illinois, licensed in IL, with an NPI issued in March 2025. Enrolled in Medicare as practitioner - nurse practitioner and practitioner - nurse practitioner.
Overview
| NPI | 1710786264 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Mar 10, 2025 |
| Last updated in NPPES | Mar 10, 2025 |
| Certified by provider | Mar 8, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Psych/Mental Health Primary | 363LP0808X | 209.031859 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (NY); Practitioner - Nurse Practitioner (OR); Practitioner - Nurse Practitioner (WA) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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