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

Last updated

Mar 13, 2008By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119

  Internal Medicine

  NPD (past)
• KSB Medical Group, Inc.

  dba KSB Optical

  • 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.