Individual
OSARETIN B IDUSUYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1118 HAMPSHIRE ST, QUINCY, IL 62301-3027
(217) 222-6550
(217) 277-2253
Mailing address
1118 HAMPSHIRE ST, QUINCY, IL 62301-3027
(217) 222-6550
(217) 277-2253
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036095609
IL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
036095609
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095609
—
IL
Enumeration date
09/29/2005
Last updated
08/19/2024
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