Individual provider Active NPI

Saji Oommen, M.D.,

  • Internal Medicine Physician
  • North Chicago, IL
National Provider Identifier
1497856330
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036088920 Issued in IL
Practice address
3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone
(224) 610-3871
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036088920 IL Primary

Addresses

Primary practice location

3001 Green Bay Rd
North Chicago, IL 60064-3048

Mailing address

3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone (224) 610-3871

Other identifiers 1

IdentifierTypeStateIssuer
036088920MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000432 IL Practitioner - Internal Medicine 9133262728 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc. Internal Medicine CurrentSince Dec 1, 2014 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Dec 1, 2014 Accepting new patients
Total Rehab PC Past Accepting new patients

Locations

6225 W Touhy Ave
Chicago, IL 60646
Phone (773) 631-2223

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5215 N California Ave
Ste 603
Chicago, IL 60625
Phone (773) 275-1020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1497856330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "224-610-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "224-610-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OOMMEN",
        "first_name": "SAJI",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036088920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088920",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.