Richard E Odonnell DO SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RICHARD E ODONNELL DO SC

Practice address

3927 W 95TH St
Evergreen Park, IL 60805-1903

Phone

(708) 799-8440

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Kim Wylie

Title

Office Manager

Phone

(708) 799-8440

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ellen M Hennecke, DO

  • Family Medicine Physician
  • Evergreen Park, IL
  • NPI 1699751156
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1144421017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18141 DIXIE HWY STE 107",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051903",
            "telephone_number": "708-799-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E ODONNELL DO SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "WYLIE",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-799-8440"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01622829",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammad Abdur Razzaque, M.D.
• Caitlin Reilly, DPT
• Reliable Home Health Care, Incorporated
• Kimberly Reule, APN, FNP
• Rhicc,LLC (Reflections of Health)
• Mikaela Rico, DO
• Luay Rifai
• Katherine M Riff, MD
• Sam Rizzo, RPH
• Robert J. Bonk, D.O., LTD.

• Family Medicine Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.