MR.OAK (NPI# 1164917720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164917720 |
| Entity Type | Organization |
| Organization Name | MR.OAK |
| Practice Address |
3510 W 79th St Chicago IL 60652-1430 |
| Mailing Address |
1629 S Prairie Ave Unit 1108 Chicago IL 60616-5059 |
| Practice Telephone | 3122598555 |
| Practice Fax Number | 7739780705 |
| Mailing Telephone | 3122598555 |
| Mailing Fax Number | 7739780705 |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |
| Authorized Official Name | DR. STEVEN SMITH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3122598555 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | MREC DT Bethesda Oaks LLC | 2 South Salisbury Street, Raleigh, NC 27601 |
| Colorado Business Entities | MREC Oakwood Colorado Investments LLC | 11610 North Community House Road, Ste 100, Charlotte, NC 28277 |
| Colorado Business Entities | MREC Oakwood Colorado IV-VI LLC | 11610 North Community House Road, Ste 100, Charlotte, NC 28277 |
| Colorado Business Entities | MREC Oakwood Colorado Ranch LLC | 11610 North Community House Road, Ste 100, Charlotte, NC 28277 |
| Street Address |
3510 W 79TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60652-1430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720039373 | Quality Home Care Services Ltd | Home Health | 3510 W 79th St, Chicago, IL 60652-1430 | 2006-05-16 |
| 1720537384 | Chicagoland Physician Consortium, LLC | Family Medicine | 3510 W 79th St, Chicago, IL 60652-1430 | 2016-09-23 |
| 1083095293 | Richard Felicelda | Spec/Tech, Cardiovascular | 3510 W 79th St, Suite 4, Chicago, IL 60652-1430 | 2015-06-12 |
| 1568753259 | Accusci Labs Inc | Clinical Medical Laboratory | 3510 W 79th St, Suite 3, Chicago, IL 60652-1430 | 2011-04-28 |
| 1427093251 | Illiana Home Medical Equipment and Supplies LLC | Durable Medical Equipment & Medical Supplies | 3510 W 79th St, Chicago, IL 60652-1430 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861042715 | New Hope Community Service Center | Clinic/Center | New Hope Community Service Center, 2559 West 79th, Chicago, IL 60652 | 2019-09-12 |
| 1770012189 | Rachel Pasternak | Social Worker | 3348 W 87th Street, Chicago, IL 60652 | 2017-06-08 |
| 1437682283 | Manliu Yang | Dentist | 8541 S Cicero Ave, Chicago, IL 60652 | 2017-04-08 |
| 1336687144 | Stephanie J. Wilson | Registered Nurse | 7600 S. Pulask Rd., Chicago, IL 60652 | 2017-02-01 |
| 1346786811 | Talisha Moman | Licensed Practical Nurse | 7600 S. Pulaski Rd., Suite 1106, Chicago, IL 60652 | 2017-01-09 |
| 1952851933 | Yvonne Caldwell | Licensed Practical Nurse | 8600 S. Pulaski, Road, Chicago, IL 60652 | 2016-10-13 |
| 1942605795 | Brittney Mclean | Developmental Therapist | 4317 W. 77th Pl, Chicago, IL 60652 | 2014-10-22 |
| 1245599521 | Chisa Marie Collins | Occupational Therapist | 8008 S Albany, Chicago, IL 60652 | 2012-05-08 |
| 1548572969 | St. Mary Therapy Services | Clinic/Center | 2455 W 79th St, #101, Chicago, IL 60652 | 2010-07-14 |
| 1750574752 | Curt R Lang | Dentist | 4651 W 79th St, Suite 208, Chicago, IL 60652 | 2007-08-22 |
| Find all providers in zip 60652 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1447666318 | M & F Medical Services, Ltd | Family Medicine | 5642 N Christiana Ave, Chicago, IL 60659-4555 | 2014-07-10 |
| 1457767774 | Rambha Radhakrishnan | Family Medicine | 2645 W Peterson Ave, Chicago, IL 60659-4017 | 2014-07-08 |
| 1730444639 | Iqbal S Husain | Family Medicine | 6936 N Chicora Ave, Chicago, IL 60646-1508 | 2012-07-07 |
| 1033480413 | Healthworks Integrative Medical Clinic | Family Medicine | 1165 N Clark St Ste 608, Chicago, IL 60610-7848 | 2012-01-18 |
| 1518123843 | Nastane Le Bec | Family Medicine | 6225 S Kenwood Ave Apt 1s, Chicago, IL 60637-3766 | 2008-08-06 |
| 1639372410 | Albert R Rosanova Jr Ltd | Family Medicine | 5510 W Montrose Ave, Chicago, IL 60641-1330 | 2007-06-07 |
| 1386860997 | Mariya Dmytriv-kapeniak | Family Medicine | 2540 W Chicago Ave, Chicago, IL 60622-5019 | 2007-04-18 |
| 1255462578 | Roberto Diaz | Family Medicine | 1805 S Ashland Ave, Chicago, IL 60608-2805 | 2007-03-08 |
| 1386784346 | Carroll Edward Smith | Family Medicine | 4215 S King Dr, Chicago, IL 60653-2663 | 2007-02-07 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on MR.OAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.