Holly J Odean, A.T.,C.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

96000796 Issued in IL

Practice address

1 Erie CT Ste 7120
Oak Park, IL 60302-2510

Phone

(708) 848-4662

NPI assigned

Mar 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114044948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4253 PRESCOTT AVE",
            "city": "LYONS",
            "state": "IL",
            "postal_code": "605341530",
            "telephone_number": "708-447-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ERIE CT STE 7120",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022510",
            "telephone_number": "708-848-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEAN",
        "first_name": "HOLLY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "A.T.,C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "96000796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Oberlies, PA-C
• Mary Beth Obeso, MD
• Objectives Behavioral Health, LLC
• Adrian Javier Ochoa
• Maureen Sauvain Oconnor, M.S.W.
• Kate Odom
• Kylii Odom
• Jennifer Ann Oh, LCPC
• Aaron Ntiri Ohemeng, D.D.S.
• Maryam Ojulari, MD

• Athletic Trainer in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.