O'Malley, Bernard Edward

O'Malley, Bernard Edward is an individual health care provider with primary practice located at 13539 Il Route 76 , Poplar Grove IL 61065-8815. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. O'Malley, Bernard Edward can be contacted via phone (815) 765-0147.

Contact Information

Primary practice address
13539 Il Route 76 Poplar Grove IL 61065-8815
Phone: (815) 765-0147
Fax: (815) 765-0427
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036047509 Illinois

Profile Details

NPI number 1164451456
LBN Legal business name O'Malley, Bernard Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2006
Last updated May 20th, 2009 - about 17 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 1164451456 NPPES
Illinois MEDICAID 036047509
Illinois Other 553180

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