Individual provider Active NPI

Oscar Roberto Linares, M.D.

  • Pediatrics Physician
  • Berwyn, IL
National Provider Identifier
1790797066
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-087151 Issued in IL
Practice address
6545 Cermak Rd
Berwyn, IL 60402-2313
Phone
(708) 788-0077
Fax
(708) 788-5620
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
Yes

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
Pediatrics Physician 208000000X 036-087151 IL Primary

Addresses

Primary practice location

6545 Cermak Rd
Berwyn, IL 60402-2313

Mailing address

6545 Cermak Rd
Berwyn, IL 60402-2313
Phone (708) 788-0077

Other identifiers 1

IdentifierTypeStateIssuer
036087151MedicaidIL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-087151ILMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790797066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022313",
            "telephone_number": "708-788-0077",
            "fax_number": "708-788-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022313",
            "telephone_number": "708-788-0077",
            "fax_number": "708-788-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINARES",
        "first_name": "OSCAR",
        "middle_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-087151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087151",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, 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.