Organization
TAMARA OLT, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA OLT M.D. (PRESIDENT)
(309) 692-2805
Entity
Organization
Contact information
Practice address
6915 N KNOXVILLE AVE STE 1, PEORIA, IL 61614-2851
(309) 692-2805
(309) 692-1913
Mailing address
6915 N KNOXVILLE AVE STE 1, PEORIA, IL 61614-2851
(309) 692-2805
(309) 692-1913
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
—
IL
207VX0000X
Obstetrics Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07232119
BCBS GROUP NUMBER
IL
Enumeration date
09/29/2006
Last updated
03/06/2026
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