Individual provider Active NPI

Dino Gerald O'Mara, DC

  • Chiropractor
  • Mokena, IL
National Provider Identifier
1003467804
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013437 Issued in IL
Practice address
19600 S la Grange Rd
Mokena, IL 60448-9321
Phone
(708) 478-3000
Fax
(708) 478-3007
NPI assigned
Sep 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013437 IL Primary

Addresses

Primary practice location

19600 S la Grange Rd
Mokena, IL 60448-9321

Mailing address

19600 S la Grange Rd
Mokena, IL 60448-9321
Phone (708) 478-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200123001186 IL Practitioner - Chiropractic 2062847965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19600 S la Grange Rd
Mokena, IL 60448-9321
Phone (708) 478-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013437ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Frankfort Spinal Rehabilitation & Physical Therapy Inc CurrentSince Jul 10, 2023 Accepting new patients

Locations

19600 S La Grange Rd
Mokena, IL 60448
Phone (708) 478-3000

Networks

  • IL PPO Downstate
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • IL HMO C-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1003467804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19600 S LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489321",
            "telephone_number": "708-478-3000",
            "fax_number": "708-478-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 S LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489321",
            "telephone_number": "708-478-3000",
            "fax_number": "708-478-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARA",
        "first_name": "DINO",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.