Oleh Paly, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Ingleside, IL
NPI 1477574374 · NPPES record last updated Aug 26, 2009
Key facts
- NPI
- 1477574374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 036072020 (IL)
- Practice address
- 34905 N Lake Matthews TRL
Ingleside, IL 60041-9480 - Phone
- (773) 767-8283
- NPI assigned
- Jul 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036072020 | IL | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 036072020 | IL | Yes |
Addresses
Primary practice location
34905 N Lake Matthews TRL
Ingleside, IL 60041-9480
Mailing address
PO Box 388320
Chicago, IL 60638-8320
Phone (773) 767-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04905190 | Other | IL | BLUE SHIELD |
| 036072020 | Medicaid | IL |
Other providers in Ingleside, IL
- Mobilemogulruralhealthclinic
- Laure Moore
- Dana Muligano
- Diego Munoz
- Jennifer Ann O'Grady
- Marcy Patterson
- Patrice Ann Piechur
- Annie Rose Pitts
- Maria Teresa Queypo
- Nader Sallam
All providers in Ingleside, IL · Physical Medicine & Rehabilitation Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.