Individual provider Active NPI

Deborah Jean O'Brien, M.D.

  • Emergency Medicine Physician
  • Montgomery, IL
National Provider Identifier
1780778779
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036099741 Issued in IL
Practice address
1655 Timber Lane Dr
Montgomery, IL 60538-2922
Phone
(630) 660-4719
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036099741 IL
Emergency Medicine Physician 207P00000X 036099741 IL Primary

Addresses

Primary practice location

1655 Timber Lane Dr
Montgomery, IL 60538-2922

Mailing address

1655 Timber Lane Dr
Montgomery, IL 60538-2922
Phone (630) 660-4719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20130610000758 IN Practitioner - Family PracticePractitioner - Emergency Medicine 0547165193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Minnesota Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

11580 Overlook Dr
Suite 100
Fishers, IN 46037-4221
Phone (317) 845-5425

5604 W 74TH St
Concentra Urgent Care
Indianapolis, IN 46278-1752
Phone (317) 290-1551

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Mar 3, 2014 Accepting new patients
American Current Care PA CurrentSince Mar 3, 2014 Accepting new patients
Three Rivers Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Central Illinois Emergency Physicians, LLP Emergency Medicine PastSince Mar 1, 2003 Accepting new patients
Illinois Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

5604 W 74th St
Indianapolis, IN 46278
Phone (317) 290-1551

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1780778779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 TIMBER LANE DR",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605382922",
            "telephone_number": "630-660-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 TIMBER LANE DR",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605382922",
            "telephone_number": "630-660-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036099741",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036099741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, IL

Sources for this page

Verify at the official NPI Registry.