Individual provider Active NPI

Nicole Aimee Orwar, D.O.

  • Obstetrics & Gynecology Physician
  • Mokena, IL
National Provider Identifier
1396989422
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101018086 Issued in MI
Practice address
10260 191St St
Suite 100
Mokena, IL 60448-8801
Phone
(708) 425-1907
Fax
(708) 469-4358
NPI assigned
Apr 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101018086 MI Primary

Addresses

Primary practice location

10260 191St St
Suite 100
Mokena, IL 60448-8801

Mailing address

10260 191St St
Suite 100
Mokena, IL 60448-8801
Phone (708) 425-1907

Other practice location 1

9730 S Western Ave Ste 700
Evergreen Park, IL 60805-2814
Phone (708) 425-1907

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address whc@providea.gwaydirect.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130520000718 IL Practitioner - Obstetrics/Gynecology 0840438438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providea Health Partners LLCGroup PAC ID 5698904878, 7 clinicians

Practice addresses (Care Compare)

10260 191St St
Suite 100
Mokena, IL 60448-8802
Phone (708) 572-7606

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101018086MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A Lota Healthcare LTD Obstetrics & Gynecology CurrentSince Jan 26, 2022 Accepting new patients

Locations

9730 S Western Ave
Ste 700
Evergreen Pk, IL 60805
Phone (708) 425-1907

10260 191st St
Ste 100
Mokena, IL 60448
Phone (708) 425-1907

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1396989422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 191ST ST",
            "address_2": "SUITE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488801",
            "telephone_number": "708-425-1907",
            "fax_number": "708-469-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 191ST ST",
            "address_2": "SUITE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488801",
            "telephone_number": "708-425-1907",
            "fax_number": "708-469-4358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 S Western Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052814",
            "country_code": "US",
            "telephone_number": "708-425-1907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORWAR",
        "first_name": "NICOLE",
        "middle_name": "AIMEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101018086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whc@providea.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "EHR secure mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR secure mail",
            "address_1": "10260 191st St",
            "address_2": "Suite 100",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604488801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.