Individual
MARY BETH OBESO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 LAKE ST, SUITE 210, OAK PARK, IL 60301-1015
(708) 848-4188
(708) 524-2142
Mailing address
1100 LAKE ST, SUITE 210, OAK PARK, IL 60301-1015
(708) 524-2131
(708) 524-2142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036095647
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615849
BCBS
IL
05
—
036095647
—
IL
Enumeration date
01/16/2006
Last updated
03/24/2021
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