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General NPI Number Information
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NPI Number | 1144660085
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Entity Type | Organization
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Legal Business Name | OAK STREET HEALTH PHYSICIANS GROUP PC
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 30 W MONROE ST STE 1200
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City | CHICAGO
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State | IL
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Zip | 60603-2420
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Country | US
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Telephone | 773-352-1515
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Fax | 312-929-0373
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Provider Business Mailing Address
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Address Line | PO BOX 746721
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City | ATLANTA
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State | GA
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Zip | 30374-6721
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Country | US
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Telephone | 773-352-1515
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Fax | 312-929-0373
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID G. FAIRCHILD
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Credential |
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Telephone | 508-334-8780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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