Provider Demographics
NPI:1295882876
Name:OAK MILL MEDICAL ASSOCIATES SC
Entity type:Organization
Organization Name:OAK MILL MEDICAL ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALESSI
Authorized Official - Suffix:
Authorized Official - Credentials:CMA, CPC, CMM
Authorized Official - Phone:847-663-9700
Mailing Address - Street 1:7900 N MILWAUKEE AVE
Mailing Address - Street 2:STE 18
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3159
Mailing Address - Country:US
Mailing Address - Phone:847-663-9700
Mailing Address - Fax:847-663-9773
Practice Address - Street 1:7900 N MILWAUKEE AVE
Practice Address - Street 2:STE 18
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3159
Practice Address - Country:US
Practice Address - Phone:847-663-9700
Practice Address - Fax:847-663-9773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042-617261261QP2300X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL596750Medicare ID - Type Unspecified