Mr.Oak

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

MR.OAK

Practice address

3510 W 79TH St
Chicago, IL 60652-1430

Phone

(312) 259-8555

Fax

(773) 978-0705

NPI assigned

Jun 26, 2018

Last updated

Jun 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Steven Smith, MDNPI 1114360013

Title

Medical Director

Phone

(312) 259-8555

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Smith, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1114360013
  NPD Authorized official

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1164917720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 S PRAIRIE AVE UNIT 1108",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606165059",
            "telephone_number": "312-259-8555",
            "fax_number": "773-978-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606521430",
            "telephone_number": "312-259-8555",
            "fax_number": "773-978-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MR.OAK",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-259-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.