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

Osayama Jacquelyn Omoruyi

Individual provider Physical Therapist · NPI 1275490054

Osayama Jacquelyn Omoruyi is a Physical Therapist in Private Practice in Chicago, Illinois. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2026
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Practice location Address checks out

1220 N State Pkwy # 1600
Chicago, IL 60610-8112
Phone: (562) 751-7009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070.029624 (IL)

Record details

NPI number1275490054
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 5, 2026
Last updated in NPPESMarch 16, 2026
Certification dateMarch 16, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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