Provider Demographics
NPI:1124025754
Name:O'LEARY, JOHN FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:O'LEARY
Suffix:
Gender:M
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:PO BOX 27015
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-0015
Mailing Address - Country:US
Mailing Address - Phone:402-393-9459
Mailing Address - Fax:402-397-9895
Practice Address - Street 1:2545 CHICAGO AVE S
Practice Address - Street 2:STE 510
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404
Practice Address - Country:US
Practice Address - Phone:952-285-6879
Practice Address - Fax:952-285-6890
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24502208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30712800Medicaid
WI30712800Medicaid