Prakash Raj Oli, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.083136 Issued in IL

Practice address

1500 S Fairfield Ave # F-908
Chicago, IL 60608-1782

Phone

(773) 257-5701

Fax

(773) 257-6027

NPI assigned

Jun 27, 2024

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1831934207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE # F-908",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-5701",
            "fax_number": "773-257-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE # F-908",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-5701",
            "fax_number": "773-257-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLI",
        "first_name": "PRAKASH",
        "middle_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.083136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.