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

Omolola Nicole Ometoruwa

Individual provider Physician Assistant · NPI 1962298398

Omolola Nicole Ometoruwa is a Physician Assistant in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2025
Specialties on file
2

Practice location Address checks out

3501 N Halsted St
Chicago, IL 60657-1832
Phone: (773) 388-1600
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X · Licence 085.012277 (IL)

Record details

NPI number1962298398
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 15, 2025
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026

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