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Individual

LAURA A OSWALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
7 BLANCHARD CIR, SUITE 200, WHEATON, IL 60187-2039
(630) 510-9009
(630) 510-0152
Mailing address
7 BLANCHARD CIR, SUITE 200, WHEATON, IL 60187-2039
(630) 510-9009
(630) 510-0152

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036108633
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0222075
BLUE CROSS GROUP NUMBER
IL
05
036108633
IL
01
920540
MEDICARE PTAN (GROUP)
IL
01
L98989
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
07/05/2006
Last updated
04/03/2015
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