Abidemi Balogun, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Marshall, Illinois. She graduated from nursing school in 2023 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fabian Carbonell Md Sc and her current practice location is
410 N 2nd St, Marshall, Illinois. You can reach out to her office (for appointments etc.) via phone at
(718) 506-1115.
Abidemi Balogun is licensed to practice in Illinois (license number 209028750) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1205605235.
Provider's Profile
| Full Name | Abidemi Balogun |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 410 N 2nd St, Marshall, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Abidemi Balogun graduated from nursing school in 2023
NPI Data:
- NPI Number: 1205605235
- Provider Enumeration Date: 01/02/2024
- Last Update Date: 01/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 3173975778
- Enrollment ID: I20240119000372
Medical Identifiers
Medical identifiers for Abidemi Balogun such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205605235 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209028750 (Illinois) | Primary |
Medical Facilities Affiliation
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Abidemi Balogun allows following entities to bill medicare on her behalf.
| Entity Name | Fabian Carbonell Md Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578767935
PECOS PAC ID: 7416980172
Enrollment ID: O20050913001117 |
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| Entity Name | Supportive Care Of Illinois Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861199911
PECOS PAC ID: 7113392804
Enrollment ID: O20230411002061 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Abidemi Balogun is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Abidemi Balogun, PMHNP
1372 Fargo Ave Apt B,
Des Plaines, IL 60018-2991
Ph: () - | Abidemi Balogun, PMHNP
410 N 2nd St,
Marshall, IL 62441-1010
Ph: (718) 506-1115 |
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