Individual
MRS. MARY ANN OSTENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
755 W GALENA AVE, FREEPORT, IL 61032-0655
(815) 235-1551
Mailing address
PO BOX 655, FREEPORT, IL 61032-0655
(815) 235-1551
(815) 235-1551
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08932008
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/10/2007
Last updated
01/05/2009
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