Active NPI
Robert Mahmarian, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Oak Forest, IL
National Provider Identifier
1184774457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Practice address
- 15900 South Cicero Ave
Oak Forest Hospital Department of Surgery
Oak Forest, IL 60452 - Phone
- (708) 687-7200
- Fax
- (708) 633-4198
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | IL | Primary |
Addresses
Primary practice location
15900 South Cicero Ave
Oak Forest Hospital Department of Surgery
Oak Forest, IL 60452
Mailing address
15900 South Cicero Ave
Oak Forest Hospital Department of Surgery
Oak Forest, IL 60452
Phone (708) 687-7200
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-003502 | IL | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184774457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15900 SOUTH CICERO AVE",
"address_2": "OAK FOREST HOSPITAL DEPARTMENT OF SURGERY",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "60452",
"telephone_number": "708-687-7200",
"fax_number": "708-633-4198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15900 SOUTH CICERO AVE",
"address_2": "OAK FOREST HOSPITAL DEPARTMENT OF SURGERY",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "60452",
"telephone_number": "708-687-7200",
"fax_number": "708-633-4198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHMARIAN",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oak Forest, 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.