Active NPI
Erin Kathleen O'Brien, M.D.
- Pediatrics Physician
- Lake in the Hills, IL
National Provider Identifier
1437114394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036-108-387
- Practice address
- 301 N Randall Rd
Lake in the Hills, IL 60156-5961 - Phone
- (847) 658-6065
- Fax
- (847) 658-6136
- NPI assigned
- Apr 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036108387 | IL | |
| Pediatrics Physician | 208000000X | 036-108-387 | IL | Primary |
Addresses
Primary practice location
301 N Randall Rd
Lake in the Hills, IL 60156-5961
Mailing address
301 N Randall Rd
Lake in the Hills, IL 60156-5961
Phone (847) 658-6065
Other names 1
- Mrs. Erin Kathleen Kellar
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-108-387 | IL | MD | Pediatrics Physician |
| 036108387 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Children's Medical Group, S.C. | Pediatrics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Lake in the Hills, IL
- NPI 1740483718
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1437114394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 N RANDALL RD",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "601565961",
"telephone_number": "847-658-6065",
"fax_number": "847-658-6136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N RANDALL RD",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "601565961",
"telephone_number": "847-658-6065",
"fax_number": "847-658-6136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "ERIN",
"middle_name": "KATHLEEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-20",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036108387",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-108-387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ERIN",
"last_name": "KELLAR",
"middle_name": "KATHLEEN",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lake in the Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.