Osborne, Chad
Osborne, Chad is an individual health care provider with primary practice located at 1701 E College Ave , Bloomington IL 61704-2101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Osborne, Chad can be contacted via phone (309) 664-3170.Contact Information
Primary practice address
1701 E College Ave
Bloomington IL 61704-2101
Phone: (309) 664-3170
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036095209 | Illinois |
Profile Details
| NPI number | 1235249921 |
|---|---|
| LBN Legal business name | Osborne, Chad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Aug 18th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235249921 | NPPES |
| Illinois | Other | IL2613 | MEDICARE GROUP PTAN |
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