DR. OLUSEGUN NUTAYI (DNP) – Family Nurse Practitioner, NPI 1174028021

DR. OLUSEGUN NUTAYI (DNP) is a healthcare provider. based in Downers grove, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 209017378 (IL). The NPI Number for DR. OLUSEGUN NUTAYI (DNP) is 1174028021

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. OLUSEGUN NUTAYI (DNP)
NPI
1174028021
Phone
(630) 895-2051
Address
1431 OPUS PL STE 110
Enumeration Date
23 March 2018
Last Update Date
7 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9043301024
Graduation Year
2017 (9 years ago)
PAC ID
7517220239
Group Practice PAC ID
5395159677
Professional Enrollment ID
I20180411001528
Address ID
IL606224910CH948XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for DR. OLUSEGUN NUTAYI (DNP)

  • 1431 OPUS PL STE 110

    DOWNERS GROVE, IL 605151164

    Phone: (630) 895-2051

    Fax: (630) 331-9960

    Type: Mailing

  • 4711 GOLF RD FL 12

    SKOKIE, IL 600761224

    Phone: (888) 215-8756

    Type: Mailing

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: 2018-04-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20180411001528INurse PractitionerILTBD

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 60515)

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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: 5395159677View full group profile
NameSpecialtyState
Nurse PractitionerIL
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineTX
Nurse PractitionerIL
Cardiovascular Disease (Cardiology)WI
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What is the standard ID for DR. OLUSEGUN NUTAYI (DNP) in the U.S.?
In the U.S., DR. OLUSEGUN NUTAYI (DNP) is identified by NPI 1174028021.
Is DR. OLUSEGUN NUTAYI (DNP) currently accepting referrals based on NPI status?
Registry metadata lists DR. OLUSEGUN NUTAYI (DNP) as active.
Which specialty label fits DR. OLUSEGUN NUTAYI (DNP)?
NPPES ties DR. OLUSEGUN NUTAYI (DNP) to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is DR. OLUSEGUN NUTAYI (DNP) tied to Downers Grove, Illinois?
If you are local to Downers Grove, Illinois, DR. OLUSEGUN NUTAYI (DNP) may be relevant to your search.
Can I export DR. OLUSEGUN NUTAYI (DNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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