BERNARD EDWARD O'MALLEY MD NPI 1164451456

NPI Information

  • NPI: 1164451456
  • Provider Name: BERNARD EDWARD O'MALLEY, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 13539 IL ROUTE 76
    POPLAR GROVE, IL
    ZIP 61065
  • Phone: (815) 765-0147

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NPI Details

Bernard Edward O'malley, MD is a family medicine in Poplar Grove, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Bernard Edward O'malley, MD NPI is 1164451456. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

13539 IL ROUTE 76
POPLAR GROVE, IL
ZIP 61065-815
Phone: (815) 765-0147
Fax: (815) 765-0427

The enumeration date for this NPI number is 7/1/2006 and was last updated on 5/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine036047509ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1801530MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE GROUP #
2553180OTHERILLINOISMEDICARE GROUP NUMBER
3C37257MEDICARE UPINILLINOIS
4036047509MEDICAIDILLINOIS
5553180025MEDICARE PINILLINOIS
6080047786MEDICARE ID-TYPE UNSPECIFIEDILLINOISRR INDIVIDUAL #
7CC5050MEDICARE ID-TYPE UNSPECIFIEDILLINOISRR MEDICARE GROUP #
8L60771MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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