LISA MARIE OLDHAM (NPI# 1689636904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689636904 |
| Entity Type | Individual |
| Full Name | LISA MARIE OLDHAM |
| Credential | M.D. |
| Practice Address |
1276 N Clybourn Ave Chicago IL 60610 |
| Mailing Address |
1276 N Clybourn Ave Chicago IL 60610-2089 |
| Practice Telephone | 3123371073 |
| Mailing Telephone | 3123371073 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2018-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
036-105494 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036-105494 | 05 | |
| IL | FEDERAL TAX ID | 02-0677500 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1300 W Belmont Ave, Suite 10, Chicago, IL 606573200 | 3129420099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790029098 | Lisa D Oldham | Nurse Anesthetist, Certified Registered | 364 White Oak St, Asheboro, NC 27203-5434 | 2012-11-27 |
| 1003826785 | Lisa M Oldham | Physical Therapist | 1701 Senate Blvd, Suite Ag045, Indianapolis, IN 46202-1239 | 2006-08-08 |
| Street Address |
1276 N CLYBOURN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821079088 | Near North Health Service Corporation | Clinic/Center | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2005-11-07 |
| 1821695487 | Ada Yanci Lemus I | Nurse Practitioner | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2020-10-07 |
| 1578127684 | Gerald Santangelo | Nurse Practitioner | 1276 N Clybourn Ave, Chicago, IL 60610-2003 | 2019-04-24 |
| 1326514365 | Near North Health Service Corporation | Case Management | 1276 N Clybourn Ave, Chicago, IL 60610-2003 | 2018-10-17 |
| 1720563695 | Angie Oliver | Nurse Practitioner | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2018-09-26 |
| 1013499839 | Andrew Koch | Nurse Practitioner | 1276 N Clybourn Ave, Chicago, IL 60610 | 2018-08-29 |
| 1992284889 | Shaina Herring | Midwife | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2018-08-10 |
| 1164909412 | Sarah Kehinde Nkwocha | Nurse Practitioner | 1276 N Clybourn Ave, Chicago, IL 60610 | 2018-07-19 |
| 1174014625 | Robert Scott Waller | Psychologist | 1276 N Clybourn Ave, Chicago, IL 60610 | 2018-05-21 |
| 1558864561 | Cynthia L Tran | Nurse Practitioner | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2018-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683145 | Roslyn M Jordan | Counselor | 860 N. Lasalle, Chicago, IL 60610 | 2019-11-15 |
| 1992278196 | Deangela Roberson | Specialist/Technologist, Other | 1212 N. Lasalle, Ste 100/ Surgery Center, Chicago, IL 60610 | 2019-01-10 |
| 1477053205 | Terri Lynn Tyson | Counselor | 1250 N. Dearborn St., 18b, Chicago, IL 60610 | 2018-02-19 |
| 1487153797 | Jennifer Quinn | Social Worker | 1200 N. Lasalle Street, Chicago, IL 60610 | 2018-02-02 |
| 1811415334 | Erin Conroy | Behavioral Analyst | 1400 North Lake Shore Drive Apt 8a, Chicago, IL 60610 | 2017-09-05 |
| 1659898674 | Courtney Jane Busing | Speech-Language Pathologist | 1211 N Lasalle, 903, Chicago, IL 60610 | 2017-08-30 |
| 1528503042 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 908 North State Street, Chicago, IL 60610 | 2016-12-20 |
| 1548702814 | Melissa Snyder | Counselor | 1820 N Lasalle Blvd, Counseling- Sweeting, Chicago, IL 60610 | 2016-11-17 |
| 1982146908 | Samantha Ruth Slagh | Physical Therapist | 1100 N Lasalle Street, Apt 1018, Chicago, IL 60610 | 2016-11-08 |
| 1891242426 | Stephanie Pinsler | Counselor | 100 W Chestnut, #1907, Chicago, IL 60610 | 2016-09-01 |
| Find all providers in zip 60610 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396142857 | Illinois Institute of Gynecology and Advanced Pelvic Surgery, Sc | Obstetrics & Gynecology | 1351 W Belmont Ave, Chicago, IL 60657-7195 | 2014-11-28 |
| 1477715142 | Michel Medical Assoc., S.c. | Obstetrics & Gynecology | 2600 S Michigan Ave Ste 314, Chicago, IL 60616-2860 | 2008-06-25 |
| 1477727550 | All Women's Medical Center | Obstetrics & Gynecology | 3140 W Irving Prk. Rd, Chicago, IL 60618 | 2008-04-18 |
| 1477731784 | Marianna Vardaka Md Inc | Obstetrics & Gynecology | 1087 Solutions Ctr, Chicago, IL 60677-1000 | 2008-02-08 |
| 1578747648 | Progressivecare for Women | Obstetrics & Gynecology | 676 N Saint Clair, 1800, Chicago, IL 60611 | 2007-12-24 |
| 1720273311 | Dorothy Jean Lucas | Obstetrics & Gynecology | 8346 S Rhodes Ave, 65 East 75th Street, Chicago, IL 60619-5705 | 2007-09-07 |
| 1497971931 | Helen Elizabeth Cejtin | Obstetrics & Gynecology | 1935 W Farwell Ave, Chicago, IL 60626-3102 | 2007-04-17 |
| 1427132950 | Edward S Lichtenberg | Obstetrics & Gynecology | 5086 N Elston Ave, Chicago, IL 60630-2427 | 2006-10-24 |
| 1699874560 | Anita Blanchard | Obstetrics & Gynecology | 5841south Maryland Avenue, Mc 2050, Chicago, IL 60637 | 2006-09-21 |
| 1356443147 | Melissa Lynn Gilliam | Obstetrics & Gynecology | 5841 S Maryland Ave # 2050, Chicago, IL 60637-1447 | 2006-09-02 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.