Otis Allen Md Sc

LBN: Otis Allen Md Sc
Otis Allen Md Sc is an health care organization with primary practice located at 1215 Holiday Dr , Bloomington IL 61704-2214. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty. Otis Allen Md Sc can be contacted via phone (309) 827-3881, or through Allen, Margaret A. via phone (309) 827-3881.

Contact Information

Primary practice address
1215 Holiday Dr Bloomington IL 61704-2214
Phone: (309) 827-3881
Fax: (309) 661-0234
Website:
Map and Directions
Authorized official contact:
Name: Allen, Margaret A.
Phone: (309) 827-3881

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 036064804 Illinois

Profile Details

NPI number 1457629842
LBN Legal business name Otis Allen Md Sc
DBA Doing business as
Authorized official Allen, Margaret A.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2011
Last updated Dec 13th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457629842 NPPES
Illinois MEDICAID 036064804

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