Individual
HENRY OH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
711 DIVISION ST., POLO, IL 61064
(815) 625-4790
Mailing address
101 E MILLER RD, STERLING, IL 61081-1252
(815) 625-4790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036108744
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108744
—
IL
01
—
P00045074
RAILROAD MEDICARE
—
Enumeration date
05/11/2006
Last updated
07/07/2021
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