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Physician Compare National (NPI:1972647154)

HEALTHCARE PROVIDER: DIANE L OZOG MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1972647154
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0143267484
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20101109000078
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name OZOG
Individual professional last name
Provider First Name DIANE
Individual professional first name
Provider Middle Name L
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name CHICAGO COLLEGE OF MEDICINE AND SURGERY
Individual professional's medical school
Graduation Year 1982
Individual professional's medical school graduation year
Primary Specialty ALLERGY/IMMUNOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 PEDIATRIC MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties PEDIATRIC MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name DIANE L OZOG, MDSC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 3274570510
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 3
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1331 W 75TH ST
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 303
Group Practice or individual's line 2 address
City NAPERVILLE
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 605409310
Group Practice or individual's zip code (9 digits when available)
Phone Number 6306520606
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 140231
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 EDWARD HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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