Individual provider Active NPI

Patrick O'Neal, M.D.

  • Pediatrics Physician
  • Orland Park, IL
National Provider Identifier
1447242961
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036111360 Issued in IL
Practice address
15030 S Ravinia Ave Ste 38
Orland Park, IL 60462-3258
Phone
(708) 403-1883
Fax
(708) 403-8539
NPI assigned
Aug 19, 2005
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036111360 IL Primary

Addresses

Primary practice location

15030 S Ravinia Ave Ste 38
Orland Park, IL 60462-3258

Mailing address

15030 S Ravinia Ave Ste 38
Orland Park, IL 60462-3258
Phone (708) 403-1883

Other identifiers 1

IdentifierTypeStateIssuer
036111360MedicaidIL

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

LicenseStateTypeSpecialty
036111360ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick J. O'Neal Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: poneal@141.securemail.prognocis.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1447242961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15030 S RAVINIA AVE STE 38",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623258",
            "telephone_number": "708-403-1883",
            "fax_number": "708-403-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 S RAVINIA AVE STE 38",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623258",
            "telephone_number": "708-403-1883",
            "fax_number": "708-403-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036111360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111360",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.