Individual provider Active NPI

Benjamin Obadiah Peters, DO

  • Pediatrics Physician
  • Oak Lawn, IL
National Provider Identifier
1356045868
Registry record updated May 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125.081586 Issued in IL
Practice address
4220 W 95TH St
Oak Lawn, IL 60453-2793
Phone
(312) 949-4200
Fax
(708) 423-1899
NPI assigned
Mar 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 8211821 WI
Pediatrics Physician 208000000X 125.081586 IL Primary

Addresses

Primary practice location

4220 W 95TH St
Oak Lawn, IL 60453-2793

Mailing address

8915 W Connell Ave
Milwaukee, WI 53226-3067
Phone (414) 266-2000

Other practice location 1

8915 W Connell Ave
Milwaukee, WI 53226-3067
Phone (414) 266-2000

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.081586ILMDPediatrics Physician
8211821WIMDPediatric Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777680000000",
    "number": "1356045868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 W CONNELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263067",
            "telephone_number": "414-266-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532793",
            "telephone_number": "312-949-4200",
            "fax_number": "708-423-1899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8915 W Connell Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263067",
            "country_code": "US",
            "telephone_number": "414-266-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BENJAMIN",
        "middle_name": "OBADIAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2026-05-02",
        "certification_date": "2026-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "WI",
            "license": "8211821",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.081586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2026; 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.