Kenneth S Obarski, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

016-003964 Issued in IL

Practice address

425 Huehl Rd
Unit 13
Northbrook, IL 60062-2322

Phone

(847) 504-5000

Fax

(847) 504-5015

NPI assigned

Feb 23, 2006

Last updated

May 12, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Home Physicians PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago, IL
  • NPI 1811998438
  NPD (past)
• Preferred Podiatry Group PC

  • Podiatrist
  • Chicago, IL
  • NPI 1134576143
  NPD (past)

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1457327173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10580 OLCOTT AVE",
            "city": "ST JOHN",
            "state": "IN",
            "postal_code": "463738942",
            "telephone_number": "219-558-8540",
            "fax_number": "219-627-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HUEHL RD",
            "address_2": "UNIT 13",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622322",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBARSKI",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016-003964",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IN",
            "license": "07000623A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "6000164646",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003964",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110025242",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200224560A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Ann O'Connor, RN
• Deeann R O'Donnell, PHARMD
• Faylaa O'Donnell
• Molly C O'Shea, LCSW
• Jessica O'Young
• Rosa Obregon-Greco, OTR L
• Mary B Obrien, LCSW
• Obsidian Counseling and Wellness, LLC
• Maria J Occhipinti, RBT-18-73297
• Och Infusion Clinics Illinois LLC (Option Care Health Infusion Clinics)

• Primary Podiatric Medicine Podiatrist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Primary Podiatric Medicine Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.