Active NPI
Michael J Olivieri, M.D.
- Family Medicine Physician
- Oak Lawn, IL
National Provider Identifier
1124042189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 5660 W 95TH St
Oak Lawn, IL 60453-2380 - Phone
- (708) 499-4190
- Fax
- (708) 857-4420
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
5660 W 95TH St
Oak Lawn, IL 60453-2380
Mailing address
2800 W 87TH St
Chicago, IL 60652-3831
Phone (773) 863-7511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036077442 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124042189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 W 87TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606523831",
"telephone_number": "773-863-7511",
"fax_number": "773-863-7506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5660 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532380",
"telephone_number": "708-499-4190",
"fax_number": "708-857-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVIERI",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"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 Oak Lawn, IL
Sources for this page
- 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.