Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 038005491 | IL |
NPI | 1063693794 |
---|---|
Provider Name | Dr. Theodore F Oslay |
First Address | Marion, IL 62959 |
Second Address | Marion, IL 62959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2007 |
Last Update Date | 31/12/2019 |