Provider Demographics
NPI:1760520464
Name:OCAMPO, MARGOT TULIAO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGOT
Middle Name:TULIAO
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15618 INNSBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5084
Mailing Address - Country:US
Mailing Address - Phone:773-784-5988
Mailing Address - Fax:773-784-0771
Practice Address - Street 1:1044 N MOZART ST STE 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3644
Practice Address - Country:US
Practice Address - Phone:773-292-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-096704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-096704Medicaid
IL173505Medicare ID - Type Unspecified
IL036-096704Medicaid