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NPI Code Detail

MEDICARE: DR. RAYMOND T O'HARA DPM

MEDICARE: DR. RAYMOND T O'HARA DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist016-005174IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00311695OTHERILMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669463022
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND T O'HARA DPM
Provider Business Mailing Address
First Line : 929 W HIGGINS RD
Second Line :
City : SCHAUMBURG
State : IL
Zip : 60195-3203
Country : US
Telephone Number : 847-285-4200
Fax Number : 847-885-0130
Provider Business Practice Location Address
First Line : 929 W HIGGINS RD
Second Line :
City : SCHAUMBURG
State : IL
Zip : 60195-3203
Country : US
Telephone Number : 847-285-4200
Fax Number : 847-885-0130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 07/06/2020

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