Othman A. Jibril, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

36106163 Issued in IL

Practice address

416 N Pinecrest Rd
Bolingbrook, IL 60440-2147

Phone

(630) 739-5311

NPI assigned

Dec 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN2 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

Specialty

Emergency Medicine

Education

Chicago College of Osteopathy, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
• Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Chicago Central Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1093162836
  Medicare reassignment NPD
• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667

  IN

  Medicare reassignment
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Osf Healthcare System

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Osf Healthcare System

  • Critical Access Hospital
  • Kewanee, IL
  • NPI 1871919381
  Care Compare affiliation

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801871967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N PINECREST RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402147",
            "telephone_number": "630-739-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N PINECREST RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402147",
            "telephone_number": "630-739-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIBRIL",
        "first_name": "OTHMAN",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "36106163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JBH Medical Corporation LTD
• JCB Home Health Care Services Inc
• Jean Miller Counseling Center LLC
• Katrina N Jefferson
• Emily Elise Jensen, PA
• Jilada B. Williams, DDS, PC
• Alma Jimenez
• Smita Ketan Jobanputra, M.D.
• Angela John
• Kim Bernadette Johnson, COTA/L

• Emergency Medicine Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Emergency Medicine Physician in Illinois

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.