Provider Demographics
NPI:1649473729
Name:OCONER, RONALD J (DO)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:OCONER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:IL
Mailing Address - Zip Code:60033-1821
Mailing Address - Country:US
Mailing Address - Phone:815-943-8094
Mailing Address - Fax:815-943-8645
Practice Address - Street 1:901 GRANT ST
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:IL
Practice Address - Zip Code:60033-1821
Practice Address - Country:US
Practice Address - Phone:815-943-8094
Practice Address - Fax:815-943-8645
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013538207L00000X
WI53011-21207L00000X
IL036.122284207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30042806OtherKEYSTONE MERCY
PA30563OtherHEALTH PARTNERS - FF
PA30042806OtherKEYSTONE IBC
PA1019305800003Medicaid
PA2855609000OtherPERSONAL CHOICE
PA1019305800001Medicaid
PA1019305800002Medicaid
PA30567OtherHEALTH PARTNERS - FB
PA01697OtherHEALTH PARTNERS TC
PA1970005OtherHIGHMARK BLUE SHIELD
PA1019305800001Medicaid