Active NPI
Carly B Oboudiyat, M.D.
- Neurology Physician
- Chicago, IL
National Provider Identifier
1700100237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 036135484
- Practice address
- 676 N Saint Clair St
Suite 945
Chicago, IL 60611-2927 - Phone
- (312) 695-7902
- NPI assigned
- Mar 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036135484 | IL | Primary |
Addresses
Primary practice location
676 N Saint Clair St
Suite 945
Chicago, IL 60611-2927
Mailing address
676 N Saint Clair St
Suite 945
Chicago, IL 60611-2927
Phone (312) 695-7902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1700100237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "676 N SAINT CLAIR ST",
"address_2": "SUITE 945",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112927",
"telephone_number": "312-695-7902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "676 N SAINT CLAIR ST",
"address_2": "SUITE 945",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112927",
"telephone_number": "312-695-7902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBOUDIYAT",
"first_name": "CARLY",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-26",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036135484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.