Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bukola Jumoke Omotowon

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1710786264

Bukola Jumoke Omotowon is a Nurse Practitioner in Waukegan, Illinois. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2025

Practice location Address checks out

1741 Kayla Ln Apt 3B
Waukegan, IL 60087-5805
Phone: (773) 983-8173
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209.031859 (IL)

Record details

NPI number1710786264
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 10, 2025
Last updated in NPPESMarch 10, 2025
Certification dateMarch 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Waukegan