MEDINAT OMOBOLANLE BALOGUN (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1558964239

MEDINAT OMOBOLANLE BALOGUN (NP) is a healthcare provider. based in Mokena, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 209022340 (IL). The NPI Number for MEDINAT OMOBOLANLE BALOGUN (NP) is 1558964239

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MEDINAT OMOBOLANLE BALOGUN (NP)
NPI
1558964239
Phone
Not provided
Address
10010 W 190TH PL
Enumeration Date
17 November 2020
Last Update Date
17 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8552847483
Graduation Year
2020 (6 years ago)
PAC ID
5597119248
Group Practice PAC ID
4587035225
Professional Enrollment ID
I20230928001927
Address ID
IL604352808JO1051XRDXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MEDINAT OMOBOLANLE BALOGUN (NP)

  • 10010 W 190TH PL

    MOKENA, IL 604488752

    Phone:

    Type: Mailing

  • 2848 MCDONOUGH ST

    JOLIET, IL 604361050

    Phone: (815) 730-4400

    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: 2023-09-28

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
I20230928001927INurse 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 60448)

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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: 4587035225View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Does MEDINAT OMOBOLANLE BALOGUN (NP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MEDINAT OMOBOLANLE BALOGUN (NP) uses 1558964239.
Is MEDINAT OMOBOLANLE BALOGUN (NP) still practicing?
MEDINAT OMOBOLANLE BALOGUN (NP) is currently listed as active in the public NPI registry.
What is MEDINAT OMOBOLANLE BALOGUN (NP)'s specialty?
The listing groups MEDINAT OMOBOLANLE BALOGUN (NP) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect MEDINAT OMOBOLANLE BALOGUN (NP) on a map?
Expect Mokena, Illinois as a primary anchor for MEDINAT OMOBOLANLE BALOGUN (NP) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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