Organization
JOHN F O'LEARY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYL R DINVILLE CCS-P (PHYSICIAN REIMBURSEMENT SPECIALIST)
(402) 397-5462
Entity
Organization
Contact information
Practice address
2545 CHICAGO AVE, SUITE 510, MINNEAPOLIS, MN 55404-4522
(952) 285-6879
(952) 285-6890
Mailing address
PO BOX 27015, OMAHA, NE 68127-0015
(402) 393-9459
(402) 397-9895
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
24502
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00949-OL
BCBS GROUP #
MN
05
—
30712800
—
WI
01
—
3D011OL
BCBS PIN
MN
Enumeration date
03/28/2007
Last updated
03/04/2008
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