Individual
DR. IDRIS OMOSANYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1750 E 87TH ST STE 103, CHICAGO, IL 60617-2706
(708) 268-0862
(708) 218-9112
Mailing address
1750 E 87TH ST STE 103, CHICAGO, IL 60617-2706
(800) 618-6612
(708) 218-9112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070019896
IL
Other
Enumeration date
08/28/2013
Last updated
02/26/2019
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