BOLAJOKO RENEE ADENIYI (M.D.) – Internal Medicine Physician, NPI 1104112036

BOLAJOKO RENEE ADENIYI (M.D.) is a healthcare provider. based in Oak park, Illinois. specializing in Internal Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 125060353 (IL). The NPI Number for BOLAJOKO RENEE ADENIYI (M.D.) is 1104112036

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
BOLAJOKO RENEE ADENIYI (M.D.)
NPI
1104112036
Phone
(708) 763-6908
Address
3 ERIE CT
Enumeration Date
20 June 2011
Last Update Date
31 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2068231004
Graduation Year
2011 (15 years ago)
PAC ID
2466771589
Group Practice PAC ID
6002158615
Professional Enrollment ID
I20170404000661

Contacts

SOAP Endpoint
https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:14State licenses:1Other namesUpdated within 12 months

Provider Addresses for BOLAJOKO RENEE ADENIYI (M.D.)

  • 3 ERIE CT

    OAK PARK, IL 603022519

    Phone: (708) 763-6908

    Type: Mailing

  • 3 ERIE CT STE L-700

    OAK PARK, IL 603022519

    Phone: (708) 763-6908

    Type: Location

  • 1708 YAKIMA AVE STE 120

    TACOMA, WA 984055300

    Phone: (253) 289-1363

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-04-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150512000207IInternal MedicineFLTBD
I20170404000661IInternal MedicineWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60302)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002158615View full group profile

Reviews

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Frequently asked questions

What number should I use to identify BOLAJOKO RENEE ADENIYI (M.D.) for billing?
Administrative and clinical systems typically use NPI 1104112036 for BOLAJOKO RENEE ADENIYI (M.D.).
Should I treat BOLAJOKO RENEE ADENIYI (M.D.) as an active provider?
Patients and plans typically see BOLAJOKO RENEE ADENIYI (M.D.) as active in the national extract.
What services align with BOLAJOKO RENEE ADENIYI (M.D.)'s listing?
BOLAJOKO RENEE ADENIYI (M.D.)'s public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to BOLAJOKO RENEE ADENIYI (M.D.)?
BOLAJOKO RENEE ADENIYI (M.D.) shows a connection to Oak Park, Illinois in registry-derived data.
Who maintains BOLAJOKO RENEE ADENIYI (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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