Alexander Eduard Obolsky, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036081074 Issued in IL

Practice address

53 W Jackson Blvd Ste 1260
Chicago, IL 60604-3631

Phone

(312) 456-4343

Fax

(312) 456-8304

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 6, 2016 through May 6, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Illumental Counseling and Psychiatry, PLLC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1487410007
  NPD Authorized official
• Alexander E Obolsky MD PC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1144369927
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1376682476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD STE 1260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043631",
            "telephone_number": "312-456-4343",
            "fax_number": "312-456-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD STE 1260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043631",
            "telephone_number": "312-456-4343",
            "fax_number": "312-456-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBOLSKY",
        "first_name": "ALEXANDER",
        "middle_name": "EDUARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036081074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracious Obiofuma
• Danielle Obiri, MD, MPH
• Katrina Obleada, PHD
• Michael C Oblich
• Nicholas Oblock, MD
• Ivy Obonyo
• Carly B Oboudiyat, M.D.
• Dragic M Obradovic, MD
• Erin Danielle Obradovich, L.C.S.W
• Maria Teodora Obreja, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.