Individual provider Active NPI

David William O'Brian, D.P.M.

  • Podiatrist
  • Streamwood, IL
National Provider Identifier
1821165135
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016-003127 Issued in IL
Practice address
31 S Sutton Rd
Streamwood, IL 60107-3367
Phone
(630) 830-2155
Fax
(630) 246-3398
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016-003127 IL Primary

Addresses

Primary practice location

31 S Sutton Rd
Streamwood, IL 60107-3367

Mailing address

705 Warrenville Rd Ste B
Wheaton, IL 60189-6379
Phone (630) 668-8277

Other identifiers 2

IdentifierTypeStateIssuer
480022179OtherILRAILROAD MEDICARE
22900-99OtherILBLUE CROSS & BLUE SHIELD

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120127000939 IL Practitioner - Podiatry 1759548068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Podiatry CenterGroup PAC ID 0749180636, 6 clinicians

Practice addresses (Care Compare)

2124 Ogden Ave
Suite 101
Aurora, IL 60504-7542
Phone (630) 585-8087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of nail tissue306
Removal or shaving of skin growth13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-003127ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Podiatry Center CurrentSince Sep 1, 2019 Accepting new patients
Northwest Podiatry Center CurrentSince Sep 1, 2019 Accepting new patients

Locations

2124 Ogden Ave
Ste 101
Aurora, IL 60504
Phone (630) 585-8087

3254 Sycamore Rd
DeKalb, IL 60115
Phone (815) 756-9491

13312 Village Green Dr
Huntley, IL 60142
Phone (847) 515-2030

7954 W Oakton St
Niles, IL 60714
Phone (708) 823-5510

234 Randall Rd
South Elgin, IL 60177
Phone (847) 608-9494

31 S Sutton Rd
Streamwood, IL 60107
Phone (630) 830-2155

705 Warrenville Rd
Ste B
Wheaton, IL 60189
Phone (630) 668-8277

Organizations & group practices 2

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1821165135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WARRENVILLE RD STE B",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601896379",
            "telephone_number": "630-668-8277",
            "fax_number": "630-246-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S SUTTON RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601073367",
            "telephone_number": "630-830-2155",
            "fax_number": "630-246-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIAN",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016-003127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480022179",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "22900-99",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.