Obeso, Mary Beth

Obeso, Mary Beth is an individual health care provider with primary practice located at 1100 Lake St Suite 210, Oak Park IL 60301-1015. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Obeso, Mary Beth can be contacted via phone (708) 848-4188.

Contact Information

Primary practice address
1100 Lake St Suite 210 Oak Park IL 60301-1015
Fax: (708) 524-2142
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036095647 Illinois

Profile Details

NPI number 1760461818
LBN Legal business name Obeso, Mary Beth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2006
Last updated Mar 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760461818 NPPES
Illinois Other 01615849 BCBS
Illinois MEDICAID 036095647 BCBS

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