Jacqueline Olivo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-115930 Issued in IL

Practice address

2412 W Fullerton Ave
Chicago, IL 60647-3155

Phone

(773) 384-7977

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drolivo@vs-il.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Viru SC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1922294503
  Medicare reassignment Authorized official
• Medici Healthcare Providers S.C

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1336267467
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate North Side Health Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912014564
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1295767366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5753 W DAKIN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342606",
            "telephone_number": "773-427-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473155",
            "telephone_number": "773-384-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVO",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-115930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Lares DDS PC
• Aliyah A Olivier, LPC
• Daniel John Olivieri, MD
• Maggie Bernadette Olivieri, LCSW
• Alison M Olivo, AUD
• Marcin Olkowicz, MOTR/L
• Jacob Ollech, MD
• Grady Mahalia Oller, OD
• Ayesha Ollie, LSW
• Joan Annette Ollie, NURSE PRACTITIONER

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, 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 Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.