Individual
CANDICE J. M. OSENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
275 SOUTH UNIVERSITY STREET, 211 RACHEL COOPER, NORMAL, IL 61761
(309) 438-8641
(309) 438-5221
Mailing address
CAMPUS BOX 4720, ECKELMANN-TAYLOR SPEECH AND HERAING CLINIC, NORMAL, IL 61790-4720
(309) 438-8641
(309) 438-5221
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147-001150
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207414
MEDICARE GROUP NO.
—
Enumeration date
07/16/2006
Last updated
09/12/2012
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