DYNASTY 57 BEHAVIORAL HEALTH LLC
NPI 1689538563
Nurse Practitioner - Psychiatric/Mental Health in Chicago, IL
About Dynasty 57 Behavioral Health Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DYNASTY 57 BEHAVIORAL HEALTH LLC (NPI 1689538563) is a healthcare organization registered as a psychiatric/mental health in Chicago, Illinois and active in the NPI registry since December 2025. The organization lists Modupe Ojuetimi Olukeye, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dynasty 57 Behavioral Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Dynasty 57 Behavioral Health LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dynasty 57 Behavioral Health LLC's NPI number?
The NPI number for Dynasty 57 Behavioral Health LLC is 1689538563. It was assigned to this organization in the NPPES registry on December 15, 2025.
Where is Dynasty 57 Behavioral Health LLC located?
Dynasty 57 Behavioral Health LLC is located at 2206 W Greenleaf Ave, Chicago, IL 60645. The listed phone number is (773) 234-1067.
What is Dynasty 57 Behavioral Health LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Dynasty 57 Behavioral Health LLC enrolled in Medicare?
Yes. Dynasty 57 Behavioral Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Dynasty 57 Behavioral Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Dynasty 57 Behavioral Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Dynasty 57 Behavioral Health LLC was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dynasty 57 Behavioral Health Llc · NPI 1689538563
Psychiatric/Mental Health organization in Chicago, Illinois. Organization record, active in the CMS NPPES registry since December 15, 2025.
## Identity
- **NPI:** 1689538563 (Entity type: Organization)
- **Enumerated:** December 15, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Modupe Olukeye, OWNER
## Practice location
- **Address:** 2206 W GREENLEAF AVE, Chicago, IL 60645-4804
- **Phone:** (773) 234-1067
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 16, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1689538563) · Data from the CMS NPPES public registry.