Mathew Oommen MD SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MATHEW OOMMEN MD SC

Practice address

6449 S Pulaski Rd
Ste#110
Chicago, IL 60629-5148

Phone

(773) 585-0001

Fax

(630) 920-0395

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mathew Oommen, MD SC

Title

Owner

Phone

(773) 585-0001

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154540730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6449 S PULASKI RD",
            "address_2": "STE#110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-585-0001",
            "fax_number": "630-920-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6449 S PULASKI RD",
            "address_2": "STE#110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-585-0001",
            "fax_number": "630-920-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHEW OOMMEN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OOMMEN",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-585-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD SC"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21607634",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Mathes, LSW
• Kimberly Mathes
• Marly Mathes, LCSW
• Matheson Counseling PLLC
• Jarom Matheson, LCSW
• A. K. Mathew, M.D.
• Amanda Mathew, MD
• Amanda R Mathew, PHD
• Anitha Elizabeth Mathew, M.D.
• Annamma Mathew, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.