Odiseo Jimenez

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125.085992 Issued in IL

Practice address

600 S Paulina St
Chicago, IL 60612-3806

Phone

(510) 386-5421

NPI assigned

Jun 5, 2025

Last updated

Jul 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1629962428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "510-386-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ODISEO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.085992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisset Jimenez, MA
• Lissette Jimenez, LSW
• Michelle Jimenez, L.AC.
• Miguel A Jimenez, D.C., S.A.
• Naomi Jimenez, LCSW
• Paula Andrea Jimenez
• Perla Jimenez
• Rosita C. Jimenez, PERIODONTIST
• Rossy Jimenez, CCC-SLP
• Sandra Jimenez, BSN RN

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.