Healthcare Provider Details

I. General information

NPI: 1871548875
Provider Name (Legal Business Name): JOSEPH OLINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 TOWER CT SUITE 300
GURNEE IL
60031-3336
US

IV. Provider business mailing address

2650 RIDGE AVE EVANSTON HOSPITAL RM 1210
EVANSTON IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 847-599-8899
  • Fax: 847-599-8897
Mailing address:
  • Phone: 847-570-1206
  • Fax: 847-570-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number036100473
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: