NPIMap

Individual provider Active NPI

Eileen Anne O'Halloran, M.D.

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1447549571
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2024028245 Issued in MO
Practice address
607 S New Ballas Rd Ste 2350
Saint Louis, MO 63141-0001
Phone
(314) 251-1340
NPI assigned
Mar 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036.134096 IL
Surgery Physician 208600000X 2024028245 MO Primary

Addresses

Primary practice location

607 S New Ballas Rd Ste 2350
Saint Louis, MO 63141-0001

Mailing address

607 S New Ballas Rd Ste 2350
Saint Louis, MO 63141-0001
Phone (314) 251-1340

Other practice location 1

10050 Kennerly Rd Ste 2500
Saint Louis, MO 63128-2195
Phone (314) 525-4440

Other identifiers 2

IdentifierTypeStateIssuer
125.060396OtherILSTATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
036.134096OtherILILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

Other names 1

  • Eileen Anne Bock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200910000118 IL Practitioner - General Surgery 8426359217 Reassigns benefits to 1 organization
I20240910001027 MO Practitioner - General Surgery 8426359217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians

Practice addresses (Care Compare)

10050 Kennerly Rd
Suite 25200
Saint Louis, MO 63128-2106
Phone (314) 525-4440

607 S New Ballas Rd
3100 Mercy Clinic Surgical Oncology Dav
Saint Louis, MO 63141-8219
Phone (314) 251-1340

621 S New Ballas Rd
Suite 3005B
Saint Louis, MO 63141-8266
Phone (314) 567-5850

851 E 5TH St
Suite 108
Washington, MO 63090-3128
Phone (636) 861-7870

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.134096ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Surgery CurrentSince Mar 1, 2020 Accepting new patients
Mercy Clinic Surgical Specialists, LLC Surgery CurrentSince Sep 3, 2024 Accepting new patients
Mercy Clinic GYN Oncology, LLC PastSince Sep 9, 2021 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

1801 W Taylor St
#3F
Chicago, IL 60612
Phone (312) 355-4300

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

5668 E State St
Rockford, IL 61108
Phone (815) 229-7580

607 S New Ballas Rd
Ste 2350
Saint Louis, MO 63141
Phone (314) 251-1340

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

Interoperability endpoints

  • Direct secure messaging: ebock89473@uihealth.direct-ci.com

Organizations & group practices 6

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 12

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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1447549571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 2350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631410001",
            "telephone_number": "314-251-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 2350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631410001",
            "telephone_number": "314-251-1340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10050 Kennerly Rd Ste 2500",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282195",
            "country_code": "US",
            "telephone_number": "314-525-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'HALLORAN",
        "first_name": "EILEEN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.134096",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2024028245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "125.060396",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "036.134096",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "BOCK",
            "middle_name": "ANNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.