Dr Jack Edgar Osterhaus, DDS is a
Dentist - General Practice based in Lasalle, Illinois. Dr Jack Edgar Osterhaus is licensed to practice in Illinois (license number 019.029567) and his current practice location is
2424 Chartres Street, Lasalle, Illinois. He can be reached at his office (for appointments etc.) via phone at
(815) 223-6013.
NPI number for Dr Jack Edgar Osterhaus is 1427480177 and his current mailing address is 2424 Chartres Street, Lasalle, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1427480177.
Healthcare Provider's Profile
| Full Name | Dr Jack Edgar Osterhaus |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 2424 Chartres Street, Lasalle, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1427480177
- Provider Enumeration Date: 08/05/2013
- Last Update Date: 08/05/2013
Medical Identifiers
Medical identifiers for Dr Jack Edgar Osterhaus such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427480177 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 019.029567 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Edgar Osterhaus is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack Edgar Osterhaus, DDS
2424 Chartres Street,
Lasalle, IL 61301-1107
Ph: (815) 223-6013 | Dr Jack Edgar Osterhaus, DDS
2424 Chartres Street,
Lasalle, IL 61301-1107
Ph: (815) 223-6013 |
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