Individual
DR. OSAMA AAFLAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 549-0721
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-089155
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089155
—
IL
01
—
3932056
BLUE SHIELD
IL
Enumeration date
05/10/2006
Last updated
11/09/2020
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