Individual
DR. JOE O'SABEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6451 E RIVERSIDE BLVD, SUITE 103, ROCKFORD, IL 61114-4421
(815) 639-9900
Mailing address
6451 E RIVERSIDE BLVD, SUITE 103, ROCKFORD, IL 61114-4421
(815) 639-9900
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
036.118972
IL
208D00000X
General Practice Physician
036.118972
IL
208VP0000X
Pain Medicine Physician
Primary
036.118972
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210693
MEDICARE GROUP #
IL
Enumeration date
06/28/2006
Last updated
12/29/2010
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