Individual
OLATUBOSUN ODUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3707 DOTY RD STE H, WOODSTOCK, IL 60098-7530
(815) 206-2800
(815) 337-5491
Mailing address
3707 DOTY RD STE H, WOODSTOCK, IL 60098-7530
(815) 206-2800
(815) 337-5491
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
216736
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100713-02
AMERICHOICE
NY
05
—
02112912
—
NY
01
—
1000006625
AFFINITY HEALTH
NY
01
—
112940201
HEALTH PLUS
NY
01
—
1R0921
EMPIRE BCBS
NY
01
—
2031247
UNITED HEALTH CARE
NY
01
—
216736
HIP
NY
01
—
216736-A15
HEALTH FIRST
NY
01
—
2592835
AETNA USHC PPO
NY
01
—
2697890
GHI
NY
01
—
2C9466
HEALTH NET
NY
01
—
7440270
AETNA PPO
NY
01
—
OO6736
ATLANTIS HEALTH PLAN
NY
01
—
P2164401
OXFORD HEALTH PLAN
NY
Enumeration date
09/14/2005
Last updated
03/14/2024
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