Teresa Christine Olivares, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036083593 Issued in IL

Practice address

15505 E 127TH St
Lemont, IL 60439-4433

Phone

(630) 857-3545

Fax

(630) 857-3545

NPI assigned

Mar 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119

  Internal Medicine

  NPD (past)
• KSB Medical Group, Inc.

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD (past)

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1700057015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6484 COACH HOUSE RD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323215",
            "telephone_number": "630-857-3545",
            "fax_number": "630-857-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15505 E 127TH ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394433",
            "telephone_number": "630-857-3545",
            "fax_number": "630-857-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "TERESA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036083593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leena Nubani
• Christine O'Keefe
• Sherry A O'Malley, PHARMD
• Lauren O'Rourke
• Marie T Oconnor Parker, MD
• Merna Osman, PHARMD,
• Amber Ott
• Kelly Ottenstroer
• Joy M Pacelli, PHARM D
• Allison Marie Pachina, R.D.H.

• Internal Medicine Physician in Lemont, IL
• Providers in Lemont, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.