NPIMap

Organization Active NPI

Odonoghue & Odonoghue SC

  • Dermatology Physician
  • Oak Brook, IL
National Provider Identifier
1831187020
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036040480 Issued in IL
Legal business name
ODONOGHUE & ODONOGHUE SC
Practice address
120 Oak Brook Center Mall
Ste 410
Oak Brook, IL 60523-1806
Phone
(630) 574-5860
Fax
(630) 574-5866
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Dr. Marianne N O'Donoghue, M.D.
Title
Owner
Phone
(630) 574-5860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 036040480 IL Primary

Addresses

Primary practice location

120 Oak Brook Center Mall
Ste 410
Oak Brook, IL 60523-1806

Mailing address

120 Oak Brook Center Mall
Ste 410
Oak Brook, IL 60523-1806
Phone (630) 574-5860

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1831187020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OAK BROOK CENTER MALL",
            "address_2": "STE 410",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806",
            "telephone_number": "630-574-5860",
            "fax_number": "630-574-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OAK BROOK CENTER MALL",
            "address_2": "STE 410",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806",
            "telephone_number": "630-574-5860",
            "fax_number": "630-574-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODONOGHUE & ODONOGHUE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "O'DONOGHUE",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-574-5860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036040480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.