Organization
EOHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUSEUN OSINOWO (MEMBER)
(773) 997-8757
Entity
Organization
Contact information
Practice address
1718 W NORTH SHORE AVE APT 11, CHICAGO, IL 60626-4030
(773) 997-8757
Mailing address
1718 W NORTH SHORE AVE APT 11, CHICAGO, IL 60626-4030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/21/2020
Last updated
07/26/2021
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