Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

OB GYN Care LLC

Organization Obstetrics & Gynecology Physician · NPI 1790945103

OB GYN Care LLC is an Obstetrics & Gynecology Physician in O Fallon, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1512 N Green Mount Rd Ste 107
O Fallon, IL 62269-1953
Phone: (618) 628-1717
Fax: (618) 628-1789
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 036097979 (IL)
Surgery Physician Taxonomy 208600000X · Licence 036097979 (IL)

Record details

NPI number1790945103
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bradley Tissier — Member · (618) 628-1717
NPI enumeratedJune 10, 2008
Last updated in NPPESJune 10, 2008
Mailing address1512 N Green Mount Rd, Suite 107, O Fallon, IL 62269-1953

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