MOFOLUWA AMIYAN – Nurse Practitioner, NPI 1558787960

MOFOLUWA AMIYAN is a healthcare provider. based in Richton park, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209011157 (IL). The NPI Number for MOFOLUWA AMIYAN is 1558787960

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
MOFOLUWA AMIYAN
NPI
1558787960
Phone
(708) 244-7449
Address
4512 JEFFERSON DR
Enumeration Date
10 March 2014
Last Update Date
25 February 2019

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
7734131700
Graduation Year
2012 (14 years ago)
PAC ID
6103058565
Group Practice PAC ID
3173611738
Professional Enrollment ID
I20140417000552
Address ID
IL606441580CH5730XRDXX402
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MOFOLUWA AMIYAN

  • 4512 JEFFERSON DR

    RICHTON PARK, IL 604711852

    Phone: (708) 244-7449

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 37 Open Payments records for all available years, with a total value of $1,161.

Total Amount is formed as General ($1,161) + Research ($0) + Ownership ($0) = $1,161.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($372).

Total Amount

$1,161

General + Research + Ownership

Payments

37

Total payment records

General Amount

$1,161

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2014-04-17

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
I20140417000552INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9425$0
View full utilization report →

Insurance plans in this area (ZIP 60471)

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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: 3173611738View full group profile
NameSpecialtyState
Mental Health CounselorIL
-CA
-IL
Nurse PractitionerIL
Clinical Social WorkerIL
Clinical PsychologistIL
-IL
Clinical Social WorkerIL
Mental Health CounselorIL
-IL

Reviews

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Frequently asked questions

What number should I use to identify MOFOLUWA AMIYAN for billing?
Administrative and clinical systems typically use NPI 1558787960 for MOFOLUWA AMIYAN.
Quick check: is MOFOLUWA AMIYAN active?
Public NPPES data shows MOFOLUWA AMIYAN with an active NPI status right now.
Which specialty label fits MOFOLUWA AMIYAN?
NPPES ties MOFOLUWA AMIYAN to Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MOFOLUWA AMIYAN?
The directory associates MOFOLUWA AMIYAN with Richton Park, Illinois. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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