| Osafo Health Care Clinic Inc | |
|
303 Quadrangle Dr Bolingbrook IL 60440-3409 | |
| (630) 771-1070 | |
| (630) 771-1030 |
| Full Name | Osafo Health Care Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 303 Quadrangle Dr, Bolingbrook, Illinois |
| Authorized Official Name and Position | Seth K Osafo (PRESIDENT) |
| Authorized Official Contact | 3096903369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osafo Health Care Clinic Inc 1107 W Cayman Cv Peoria IL 61615-4301 Ph: (309) 690-3369 | Osafo Health Care Clinic Inc 303 Quadrangle Dr Bolingbrook IL 60440-3409 Ph: (630) 771-1070 |
| NPI Number | 1114106978 |
|---|---|
| Provider Enumeration Date | 10/29/2007 |
| Last Update Date | 10/29/2007 |
| Medicare PECOS PAC ID | 5799863155 |
|---|---|
| Medicare Enrollment ID | O20080425000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114106978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Illinois) | Primary |
| Provider Name | Seth K Osafo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841330537 PECOS PAC ID: 1355240482 Enrollment ID: I20040107000636 |
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