Individual provider Active NPI

Jeffrey Oh

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1528972833
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
69101 Issued in CA
Practice address
2718 W Roscoe St
Chicago, IL 60618-5910
Phone
(773) 961-3000
NPI assigned
Oct 1, 2026
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 69101 CA Primary

Addresses

Primary practice location

2718 W Roscoe St
Chicago, IL 60618-5910

Mailing address

34781 Dorado CMN
Fremont, CA 94555-2727
Phone (510) 896-5454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1528972833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34781 DORADO CMN",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552727",
            "telephone_number": "510-896-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185910",
            "telephone_number": "773-961-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "69101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.