MEDICARE: DR. PATRICK M O'MEARA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036101830	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437127891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK M O'MEARA M.D.

Provider Business Mailing Address
First Line	:	1860 PAYSHERE CIR
Second Line	:	SUITE 101
City	:	CHICAGO
State	:	IL
Zip	:	60674-0001
Country	:	US
Telephone Number	:	630-279-8771
Fax Number	:	630-279-8576

Provider Business Practice Location Address
First Line	:	133 E BRUSH HILL RD STE 401
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-5659
Country	:	US
Telephone Number	:	630-932-2020
Fax Number	:	630-348-3078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	05/04/2021

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