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NPI 1386924652 · Family Medicine Physician · Chicago, IL
Provider details
- NPI number
- 1386924652
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Thomas O'Bryan, Chief Science Officer, President(877) 458-8361
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nutrition Chiropractor111NN1001X
Chiropractic Providers
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6749 N Lakewood Ave
Suite 3-N
Chicago, IL 60626-4335
Phone: (877) 458-8361
Fax: (877) 458-7656
Street-level locationGet directions
Mailing address
6749 N Lakewood Ave
Chicago, IL 60626-4335
Registry dates
- Enumerated
- 2011-08-18
- Last updated
- 2011-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.