Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016005181 | IL |
NPI | 1073629531 |
---|---|
Provider Name | Michael R. Oster |
First Address | Chicago, IL 60634-2618 |
Second Address | Chicago, IL 60634-2618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 22/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001621735 | BCBS (01) | IL |
016005181 | (05) | IL |
V10225 | (02) | IL |