Individual provider Active NPI

Diane L Ozog, MD

  • Allergy & Immunology Physician
  • Naperville, IL
National Provider Identifier
1972647154
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
036067853 Issued in IL
Practice address
1331 W 75TH St Ste 303
Naperville, IL 60540-9311
Phone
(630) 652-0606
Fax
(630) 652-9900
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 036067853 IL
Allergy & Immunology Physician 207K00000X 036067853 IL Primary

Addresses

Primary practice location

1331 W 75TH St Ste 303
Naperville, IL 60540-9311

Mailing address

1331 W 75TH St Ste 303
Naperville, IL 60540-9311
Phone (630) 652-0606

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
I20101109000078 IL Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 0143267484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Chicago College of Medicine and Surgery, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diane L Ozog, MDSCGroup PAC ID 3274570510, 2 clinicians

Practice addresses (Care Compare)

1288 Rickert Dr
Suite 100
Naperville, IL 60540-8901
Phone (630) 652-0606

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036067853ILMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diane L Ozog, MDSC Allergy & Immunology CurrentSince Oct 1, 1993 Accepting new patients

Locations

130 S Main St
Ste 202
Lombard, IL 60148
Phone (630) 652-0606

1331 W 75th St
Ste 303
Naperville, IL 60540
Phone (630) 652-0606

1288 Rickert Dr
Ste 100
Naperville, IL 60540
Phone (630) 652-0606

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 1

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1972647154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 W 75TH ST STE 303",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409311",
            "telephone_number": "630-652-0606",
            "fax_number": "630-652-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W 75TH ST STE 303",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409311",
            "telephone_number": "630-652-0606",
            "fax_number": "630-652-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZOG",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "IL",
            "license": "036067853",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036067853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.