Organization
BETTER LIFE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUSOLA OLOWE MD (CEO)
(312) 933-0661
Entity
Organization
Contact information
Practice address
3325 WILLOWCREEK RD, PORTAGE, IN 46368-5015
(312) 933-0661
Mailing address
8334 BEECH AVE, MUNSTER, IN 46321-1440
(312) 933-0661
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300013117
—
IN
Enumeration date
07/05/2020
Last updated
07/05/2020
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