Individual provider Active NPI

Olivia Esther Patch, M.D.

  • Internal Medicine Physician
  • Oak Forest, IL
National Provider Identifier
1780790527
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
15900 South Cicero
Oak Horest Hospital Room H2700
Oak Forest, IL 60452
Phone
(708) 633-4285
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

15900 South Cicero
Oak Horest Hospital Room H2700
Oak Forest, IL 60452

Mailing address

9844 S Seeley Ave
Chicago, IL 60643-1733
Phone (773) 445-2548

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

State licenses

LicenseStateTypeSpecialty
036-062598ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780790527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9844 S SEELEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431733",
            "telephone_number": "773-445-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 SOUTH CICERO",
            "address_2": "OAK HOREST HOSPITAL ROOM H2700",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "60452",
            "telephone_number": "708-633-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATCH",
        "first_name": "OLIVIA",
        "middle_name": "ESTHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.