Individual provider Active NPI

Ekta Ohri, D.O.

  • Family Medicine Physician
  • Addison, IL
National Provider Identifier
1043301773
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
220 E Lake St
Suite 100
Addison, IL 60101-2887
Phone
(630) 516-0434
Fax
(630) 516-0419
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

220 E Lake St
Suite 100
Addison, IL 60101-2887

Mailing address

220 E Lake St
Suite 100
Addison, IL 60101-2887
Phone (630) 516-0434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050414000732 IL Practitioner - General Practice 0749227304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Street Family Medicine LLCGroup PAC ID 3072530237, 2 clinicians

Practice addresses (Care Compare)

220 E Lake St
Suite 100
Addison, IL 60101-2867
Phone (630) 516-0434

Hospital & facility affiliations

  • Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-107627ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Street Family Medicine, LLC Family Medicine CurrentSince Nov 1, 2005 Accepting new patients
Dr Paul K. Rosenberg, LTD Past Accepting new patients

Locations

220 E Lake St
Ste 100
Addison, IL 60101
Phone (630) 516-0434

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043301773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E LAKE ST",
            "address_2": "SUITE 100",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012887",
            "telephone_number": "630-516-0434",
            "fax_number": "630-516-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E LAKE ST",
            "address_2": "SUITE 100",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012887",
            "telephone_number": "630-516-0434",
            "fax_number": "630-516-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHRI",
        "first_name": "EKTA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.