Healthcare Provider Details

I. General information

NPI: 1295882876
Provider Name (Legal Business Name): OAK MILL MEDICAL ASSOCIATES SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 N MILWAUKEE AVE STE 18
NILES IL
60714-3159
US

IV. Provider business mailing address

7900 N MILWAUKEE AVE STE 18
NILES IL
60714-3159
US

V. Phone/Fax

Practice location:
  • Phone: 847-663-9700
  • Fax: 847-663-9773
Mailing address:
  • Phone: 847-663-9700
  • Fax: 847-663-9773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number042-617261
License Number StateIL

VIII. Authorized Official

Name: DENISE ALESSI
Title or Position: OFFICE ADMINISTRATOR
Credential: CMA, CPC, CMM
Phone: 847-663-9700