Lisa Oldham MD LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

036105494 Issued in IL

Legal business name

LISA OLDHAM MD LLC

Practice address

1300 W Belmont Ave
Suite 10
Chicago, IL 60657-3200

Phone

(312) 942-0099

Fax

(773) 880-2321

NPI assigned

Nov 15, 2006

Last updated

May 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Marie Oldham, MDNPI 1689636904

Title

Physician

Phone

(312) 942-0099

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Marie Oldham, M.D.

  • Gynecology Physician
  • Craig, CO
  • NPI 1689636904
  NPD (past) Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1013080613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "312-942-0099",
            "fax_number": "773-880-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "312-942-0099",
            "fax_number": "773-880-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA OLDHAM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "OLDHAM",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "312-942-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036105494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105494",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689636904",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa a. Stanton, P.C.
• Lisa Catania, PC
• Lisa Demos LCPC and Associates, LLC
• Lisa Greising
• Lisa Hoemeke, Psy.D., Inc.
• Lisa Rife, LCSW
• Edward E Lisberg, MD
• Emily Nicole Lisciandro, MS, RD, LDN
• Joel Lisen, PT
• Sarah Catherine Lisenbee, PSYD

• Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.