Individual provider Active NPI

Piotr Roman Obara, M.D.

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1730322298
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036130283 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2474
NPI assigned
Apr 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X EMC0005054 MI
Diagnostic Radiology Physician 2085R0202X 036130283 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 570-2474

Other practice location 1

2160 S 1st Ave
LUH - McGaw Entrance 0028
Maywood, IL 60153-3328
Phone (708) 216-5156

Other practice location 2

3220 Discovery Dr Ste 100
Lansing, MI 48910-8609
Phone (517) 975-8930

Other practice location 3

4660 S Hagadorn Rd Ste 410
East Lansing, MI 48823-6819
Phone (517) 353-5053

Other practice location 4

4660 S Hagadorn Rd Ste 510
East Lansing, MI 48823-6805
Phone (517) 353-5053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150812006182 IL Practitioner - Diagnostic Radiology 7012133622 Reassigns benefits to 1 organization
I20240507004461 MI Practitioner - Diagnostic Radiology 7012133622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Chicago, Pritzker School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 1155
Evanston, IL 60201-1700
Phone (847) 570-1070

4660 S Hagadorn Rd
Suite 500
East Lansing, MI 48823-6804
Phone (517) 884-4554

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036130283ILMDDiagnostic Radiology Physician
EMC0005054MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 1, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 1, 2020 Accepting new patients
Msu Health Care Inc Current Accepting new patients
Msu Health Care Inc. Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Msu Health Care Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1155
Evanston, IL 60201
Phone (847) 570-1070

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

9977 Woods Dr
Skokie, IL 60077
Phone (847) 663-8540

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

4660 S Hagadorn Rd
Ste 410
East Lansing, MI 48823
Phone (517) 884-6132

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

4660 S Hagadorn Rd
Ste 510
East Lansing, MI 48823
Phone (517) 884-7450

3220 Discovery Dr
Ste 100
Lansing, MI 48910
Phone (517) 975-8930

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1730322298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2474",
            "fax_number": "847-570-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_2": "LUH - McGaw Entrance 0028",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-5156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3220 Discovery Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489108609",
            "country_code": "US",
            "telephone_number": "517-975-8930",
            "fax_number": "517-337-4985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236819",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 510",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236805",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBARA",
        "first_name": "PIOTR",
        "middle_name": "ROMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "EMC0005054",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036130283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.