Organization Active NPI

Oakbrook Medical & Diagnostic Group

  • Neurology Physician
  • Lombard, IL
National Provider Identifier
1619117165
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036-111890 Issued in IL
Legal business name
OAKBROOK MEDICAL & DIAGNOSTIC GROUP
Practice address
2200 S Main St
Suite 214
Lombard, IL 60148-5334
Phone
(630) 364-4114
Fax
(866) 868-7320
NPI assigned
Feb 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Authorized official

Name
Dr. Jonathan I Wang, MD
Title
Ceo
Phone
(630) 364-4114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 036-111890 IL Primary

Addresses

Primary practice location

2200 S Main St
Suite 214
Lombard, IL 60148-5334

Mailing address

2200 S Main St
Suite 214
Lombard, IL 60148-5334
Phone (630) 364-4114

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1619117165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S MAIN ST",
            "address_2": "SUITE 214",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485334",
            "telephone_number": "630-364-4114",
            "fax_number": "866-868-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 S MAIN ST",
            "address_2": "SUITE 214",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485334",
            "telephone_number": "630-364-4114",
            "fax_number": "866-868-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKBROOK MEDICAL & DIAGNOSTIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-364-4114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-111890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.