Provider Demographics
NPI:1386954477
Name:OHARA, PATRICK A (DMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:OHARA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 E WOODFIELD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4836
Mailing Address - Country:US
Mailing Address - Phone:847-517-8330
Mailing Address - Fax:847-517-8331
Practice Address - Street 1:808 E WOODFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4836
Practice Address - Country:US
Practice Address - Phone:847-517-8330
Practice Address - Fax:847-517-8331
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0025161223E0200X
IL019.028334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist