O'Donnell, James R

O'Donnell, James R is an individual health care provider with primary practice located at 10745 165Th St , Orland Park IL 60467-8713. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. O'Donnell, James R can be contacted via phone (708) 364-5700.

Contact Information

Primary practice address
10745 165Th St Orland Park IL 60467-8713
Phone: (708) 364-5700
Fax: (708) 745-3120
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036.070374 Illinois

Profile Details

NPI number 1043369275
LBN Legal business name O'Donnell, James R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Aug 24th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043369275 NPPES
Illinois Other 01615715 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036070374 BLUE CROSS BLUE SHIELD

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