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

Audrey Oetomo

Individual provider Pediatric Nurse Practitioner · NPI 1457789315

Audrey Oetomo is a Nurse Practitioner in Chicago, Illinois. Qualified in 2013, 13 years ago. Practices with University of Chicago, a 1,681-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
13
Licensed in
IL
In the registry since
2013

Practice location Address checks out

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone: (888) 824-0200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 209013763 (IL)

Record details

NPI number1457789315
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 30, 2013
Last updated in NPPESOctober 24, 2022
Mailing address150 Harvester Dr, Suite 300, Burr Ridge, IL 60527-5919

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice University Of Chicago — 1681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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