Healthcare Provider Details
I. General information
NPI: 1083051643
Provider Name (Legal Business Name): OAK STREET HEALTH PHYSICIANS GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2013
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1715 E 95TH ST
CHICAGO IL
60617-4708
US
IV. Provider business mailing address
PO BOX 746721
ATLANTA GA
30374-6721
US
V. Phone/Fax
- Phone: 773-768-4437
- Fax: 773-564-3515
- Phone: 773-352-1515
- Fax: 312-929-0373
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | 036132088 |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
TERRENCE
MORTON
Title or Position: CMO
Credential:
Phone: 704-607-4835