DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) – Emergency Medicine Physician, NPI 1720142128

DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) is a healthcare provider. based in Chicago, Illinois. specializing in Emergency Medicine Physician. They hold the professional credentials MD. They hold a License No. 01047096A (IN). The NPI Number for DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) is 1720142128

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. OLUSEGUN ADEKUNLE ISHMAEL (MD)
NPI
1720142128
Phone
(312) 841-0083
Address
30 W ERIE ST
Enumeration Date
20 December 2006
Last Update Date
13 October 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2177743961
Graduation Year
1992 (34 years ago)
PAC ID
4082678685
Group Practice PAC ID
1759453178
Professional Enrollment ID
I20101216001076

Contacts

Secure Messaging
olusegun.ishmael.1@15486.direct.athenahealth.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

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Provider Addresses for DR. OLUSEGUN ADEKUNLE ISHMAEL (MD)

  • 30, West Erie Street, River North, Near North Side, Chicago, North Chicago Township, Cook County, Illinois, 60610, United States

    UNIT 801

    CHICAGO, IL 606542827

    Phone: (312) 841-0083

    Fax: (312) 475-0064

    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 7 Open Payments records for all available years, with a total value of $927.

Total Amount is formed as General ($927) + Research ($0) + Ownership ($0) = $927.

Last reported payment date: 2024-08-27 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($927).

Total Amount

$927

General + Research + Ownership

Payments

7

Total payment records

General Amount

$927

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Intuitive Surgical, Inc.$927
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: 2010-12-16

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
I20101216001076IEmergency MedicineILTBD

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 60654)

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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: 1759453178View full group profile
NameSpecialtyState
-IL

Reviews

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Frequently asked questions

How do I look up DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) by NPI?
Use NPI 1720142128 when you need to reference DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) in forms, claims, or directories.
Is DR. OLUSEGUN ADEKUNLE ISHMAEL (MD)'s NPI currently valid?
The extract we use shows DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) as active.
Does DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) list a primary specialty?
If you are matching referrals, note Emergency Medicine Physician for DR. OLUSEGUN ADEKUNLE ISHMAEL (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. OLUSEGUN ADEKUNLE ISHMAEL (MD)?
The page summarizes Chicago, Illinois for DR. OLUSEGUN ADEKUNLE ISHMAEL (MD); expand the address list for detail.
Is DR. OLUSEGUN ADEKUNLE ISHMAEL (MD) a real provider?
This page reflects official NPPES data for NPI 1720142128. Always confirm identity and privileges with the practice and licensing boards.

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