| Osf Healthcare - Medical Group - Ottawa South | |
|
1640 1st Ave Ottawa IL 61350-9214 | |
| (815) 431-9208 | |
| Not Available |
| Full Name | Osf Healthcare - Medical Group - Ottawa South |
|---|---|
| Speciality | Clinic/Center |
| Location | 1640 1st Ave, Ottawa, Illinois |
| Authorized Official Name and Position | Robert C Sehring (CEO) |
| Authorized Official Contact | 3096552850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osf Healthcare - Medical Group - Ottawa South 124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | Osf Healthcare - Medical Group - Ottawa South 1640 1st Ave Ottawa IL 61350-9214 Ph: (815) 431-9208 |
| NPI Number | 1154048833 |
|---|---|
| Provider Enumeration Date | 10/24/2022 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 9133029861 |
|---|---|
| Medicare Enrollment ID | O20221116002318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154048833 | NPI | - | NPPES |
| 999 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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