Individual provider Active NPI

Maureen Morgan O'Connor, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Bourbonnais, IL
National Provider Identifier
1558460337
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036097969 Issued in IL
Practice address
338 Larry Power Rd
Bourbonnais, IL 60914-4430
Phone
(815) 936-8909
Fax
(815) 928-5075
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036097969 IL Primary

Addresses

Primary practice location

338 Larry Power Rd
Bourbonnais, IL 60914-4430

Mailing address

PO Box 781
Kankakee, IL 60901-0781
Phone (815) 935-7256

Other identifiers 1

IdentifierTypeStateIssuer
4632039OtherILBC GROUP #

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
I20101215000667 IL Practitioner - Endocrinology 5799972865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

372 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5192
Phone (815) 954-0771

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036097969ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Solutions LLC Endocrinology, Diabetes & Metabolism CurrentSince Jan 1, 2017 Accepting new patients

Locations

372 Larry Power Rd
Ste 2
Bourbonnais, IL 60914
Phone (815) 954-0771

372 Larry Power Rd
Bourbonnais, IL 60914
Phone (815) 933-5202

Organizations & group practices 1

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 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1558460337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609010781",
            "telephone_number": "815-935-7256",
            "fax_number": "815-935-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 LARRY POWER RD",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144430",
            "telephone_number": "815-936-8909",
            "fax_number": "815-928-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN O'CONNOR",
        "first_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036097969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP #",
            "identifier": "4632039",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.