| Ottawa Osteopathic Physicians, Ltd. | |
|
645 W Main St Ottawa IL 61350 | |
| (815) 434-1977 | |
| (815) 434-2022 |
| Full Name | Ottawa Osteopathic Physicians, Ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 645 W Main St, Ottawa, Illinois |
| Authorized Official Name and Position | Terry Wayne Love (OWNER/PRESIDENT) |
| Authorized Official Contact | 8154341977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ottawa Osteopathic Physicians, Ltd. 645 W Main St Ottawa IL 61350 Ph: (815) 434-1977 | Ottawa Osteopathic Physicians, Ltd. 645 W Main St Ottawa IL 61350 Ph: (815) 434-1977 |
| NPI Number | 1851305262 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 06/25/2024 |
| Medicare PECOS PAC ID | 5294637617 |
|---|---|
| Medicare Enrollment ID | O20040124000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851305262 | NPI | - | NPPES |
| 5020224 | Other | IL | BCBS IL |
| DV3801 | Other | IL | PALMETTO GBA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Terry W Love |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124034459 PECOS PAC ID: 8729980149 Enrollment ID: I20040128000630 |
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