MEDICARE: OSF MULTI-SPECIALTY GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1073109518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSF MULTI-SPECIALTY GROUP

Provider Business Mailing Address
First Line	:	124 SW ADAMS ST
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61602-1308
Country	:	US
Telephone Number	:	309-655-2850
Fax Number	:	309-655-4878

Provider Business Practice Location Address
First Line	:	7945 S HARLEM AVE
Second Line	:
City	:	BURBANK
State	:	IL
Zip	:	60459-1600
Country	:	US
Telephone Number	:	708-907-4355
Fax Number	:	708-907-4357

Authorized Official
Title or Position	:	CEO OSF HEALTHCARE SYSTEM
Name	:	ROBERT C. SEHRING
Credential	:
Telephone Number	:	309-655-2850

Provider Enumeration Date	:	12/18/2020
Last Update Date	:	03/14/2024

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