Mary Beth Obeso, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036095647 Issued in IL

Practice address

1100 Lake St
Suite 210
Oak Park, IL 60301-1015

Phone

(708) 848-4188

Fax

(708) 524-2142

NPI assigned

Jan 16, 2006

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.bohman.obeso.1@380.direct.athenahealth.com

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.

• Alexian Brothers Corporate Health Services

  • Corporate Health Clinic/Center
  • Hanover Park, IL
  • NPI 1215018635
  NPD (past)
• West Suburban Hospital Medical Center

  dba West Suburban Skilled Nursing Unit

  • Skilled Nursing Facility
  • Oak Park, IL
  • NPI 1538206974
  NPD (past)
• West Suburban Medical Center

  dba West Suburban Health Care Physicians SVCS

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1649499096
  NPD (past)
• Wholistic Health Center of Oak Park, Inc.

  • Family Medicine Physician
  • Oak Park, IL
  • NPI 1639281967
  NPD (past)

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1760461818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE ST",
            "address_2": "SUITE 210",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011015",
            "telephone_number": "708-524-2131",
            "fax_number": "708-524-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE ST",
            "address_2": "SUITE 210",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011015",
            "telephone_number": "708-848-4188",
            "fax_number": "708-524-2142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 W Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601953607",
            "country_code": "US",
            "telephone_number": "847-952-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBESO",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036095647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095647",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01615849",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.bohman.obeso.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "361 W Golf Rd",
            "city": "Schaumburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601953607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oak Park Womens Health
• Oak Park Womens Health
• Oak-Leyden Developmental Services
• Raneen Obeidallah
• Candice Oberlies, PA-C
• Objectives Behavioral Health, LLC
• Adrian Javier Ochoa
• Maureen Sauvain Oconnor, M.S.W.
• Holly J Odean, A.T.,C.
• Kate Odom

• Family Medicine Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.