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Individual

DR. JOE O'SABEN

Active
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Individual

DR. JOE O'SABEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
036.118972
IL
208D00000X
General Practice Physician
036.118972
IL
208VP0000X
Pain Medicine Physician
Primary
036.118972
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
210693
MEDICARE GROUP #
IL
Enumeration date
06/28/2006
Last updated
12/29/2010
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