MRS. BOLANLE OMOLARA SOYANNWO BALOGUN M.D
NPI 1316122468
Internal Medicine in Chicago, IL

Q: What is Bolanle Soyannwo Balogun's NPI number?

The NPI number for Bolanle Soyannwo Balogun is 1316122468. It was assigned to this individual provider in the NPPES registry on January 8, 2008. The provider is also known as Bolanle Omolara Soyannwo M.D..

Q: What is Bolanle Soyannwo Balogun's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since January 08, 2008PECOS EnrolledAccepts Medicare Assignment

3860 W OGDEN AVE, CHICAGO, IL 60623(872) 588-3000 Get Directions Write a Review

NPPES record last updated: June 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 7, 2023, May 26, 2021, Oct 1, 2018 and 1 more (4 updates tracked since 2016).

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About Mrs. Bolanle Omolara Soyannwo Balogun M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. BOLANLE OMOLARA SOYANNWO BALOGUN M.D (NPI 1316122468) is an individual internal medicine provider in Chicago, Illinois, licensed in Illinois (125050213) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS, is affiliated with Saint Anthony Hospital, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1316122468

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameMRS. BOLANLE OMOLARA SOYANNWO BALOGUNCredential: M.D

Location Address3860 W OGDEN AVEChicago, IL 60623-2460

Mailing Address3860 W Ogden AveChicago, IL 60623-2460 · (872) 588-3000

Phone(872) 588-3000

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateJanuary 8, 2008

Last NPPES UpdateJune 29, 20234 updates tracked since enumeration

NPPES CertifiedJune 29, 2023

✔ NPI 1316122468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 125050213

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 036119645 (IL)

3860 W OGDEN AVE, Chicago, IL 60623

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Other Names 1

Former Name (1)Bolanle Omolara Soyannwo M.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Bolanle Omolara Soyannwo Balogun M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103973557

PECOS Enrollment IDI20160421001927

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Bolanle Soyannwo Balogun reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lawndale Christian Health Center

Same address

Federally Qualified Health Center (FQHC)

3860 W OGDEN AVE
Chicago, IL 60623

Reassigned Medicare billing, Illinois enrollment
147 clinicians in this Medicare group

NPI 1245289214 (773) 843-2705

Saint Anthony Health Affiliates

1.2 mi

Multi-Specialty

3059 W 26TH ST
Chicago, IL 60623

Reassigned Medicare billing, Illinois enrollment
210 clinicians in this Medicare group

NPI 1154713980 (773) 696-9490

Best Practices Inpatient Care, Ltd.

30 mi

Internal Medicine

106 BARRINGTON COMMONS CT UNIT 1790
Barrington, IL 60011

Reassigned Medicare billing, Illinois enrollment
155 clinicians in this Medicare group

NPI 1073549713 (847) 719-2220

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Anthony Hospital

Acute Care Hospitals · Chicago, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140095

Location2875 West 19th StreetChicago, IL 60623 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60623 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

74%68 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$15.77 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$67.60 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOONGYU DANIEL SONG MD

Internal Medicine