Individual provider Active NPI

Jack A. Doah, D.O.

  • Obstetrics & Gynecology Physician
  • Orland Park, IL
National Provider Identifier
1881748135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Practice address
16609 107TH St
Orland Park, IL 60467-9016
Phone
(708) 645-8080
Fax
(708) 645-8081
NPI assigned
Jan 23, 2007
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
Obstetrics & Gynecology Physician 207V00000X IL Primary

Addresses

Primary practice location

16609 107TH St
Orland Park, IL 60467-9016

Mailing address

14020 Boxwood LN
Orland Park, IL 60462-4269
Phone (708) 460-7380

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109000388 IL Practitioner - Obstetrics/Gynecology 5395708580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawn Obstetrics and Gynecology SCGroup PAC ID 6103886726, 2 clinicians

Practice addresses (Care Compare)

16609 S 107TH CT
Orland Park, IL 60467-9016
Phone (708) 645-8080

Hospital & facility affiliations

  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-094295ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawn Obstetrics and Gynecology, S.C. Obstetrics & Gynecology CurrentSince Jul 1, 1999 Accepting new patients

Locations

4901 W 79th St
Burbank, IL 60459
Phone (708) 425-9321

16609 107th St
Orland Park, IL 60467
Phone (708) 645-8080

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881748135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14020 BOXWOOD LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624269",
            "telephone_number": "708-460-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16609 107TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679016",
            "telephone_number": "708-645-8080",
            "fax_number": "708-645-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAH",
        "first_name": "JACK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.