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Individual

FRED OVSIEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 N MCCLURG CT, SUITE 4411, CHICAGO, IL 60611-3044
(312) 643-5522
(312) 643-5523
Mailing address
600 N MCCLURG CT, SUITE 4411, CHICAGO, IL 60611-3044
(312) 643-5522
(312) 643-5523

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036058090
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036058090
IL
Enumeration date
05/23/2007
Last updated
08/22/2008
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