Provider Demographics
NPI:1407035199
Name:JOHN OH MD SC
Entity Type:Organization
Organization Name:JOHN OH MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-375-8282
Mailing Address - Street 1:241 GOLF MILL CTR
Mailing Address - Street 2:SUITE 416
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:241 GOLF MILL CTR
Practice Address - Street 2:SUITE 416
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1224
Practice Address - Country:US
Practice Address - Phone:847-375-8282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty