Individual provider Active NPI

Robert C Owens, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1598707481
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036053016 Issued in IL
Practice address
8124 S Cottage Grove Ave
Chicago, IL 60619-5104
Phone
(312) 807-9272
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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 036053016 IL Primary

Addresses

Primary practice location

8124 S Cottage Grove Ave
Chicago, IL 60619-5104

Mailing address

5139 S Woodlawn Ave
Chicago, IL 60615-3901
Phone (773) 955-6050

Other identifiers 1

IdentifierTypeStateIssuer
036053016MedicaidIL

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
I20090302000627 IL Practitioner - Internal Medicine 5991861841 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036053016ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation for Outreach Services CurrentSince Jun 1, 2014 Accepting new patients
Robert Owens MD Corporation Internal Medicine CurrentSince Sep 15, 2002 Accepting new patients

Locations

8124 S Cottage Grove Ave
Chicago, IL 60619
Phone (312) 807-9272

326 W 64th St
#3
Chicago, IL 60621
Phone (773) 602-3810

326 W 64th St
Ste 3
Chicago, IL 60621
Phone (773) 602-3810

326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900

Organizations & group practices 2

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1598707481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 S WOODLAWN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153901",
            "telephone_number": "773-955-6050",
            "fax_number": "773-955-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8124 S COTTAGE GROVE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195104",
            "telephone_number": "312-807-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036053016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053016",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.