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NPI Code Detail

MEDICARE: OLUSOJI ANTHONY PETER M.D.

MEDICARE: OLUSOJI ANTHONY PETER M.D.
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
1207R00000XInternal Medicine Physician01056426AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000248273OTHERINANTHEM

General Provider Information

NPI Number : 1225018203
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLUSOJI ANTHONY PETER M.D.
Provider Business Mailing Address
First Line : 11000 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-3909
Country : US
Telephone Number : 219-750-9389
Fax Number :
Provider Business Practice Location Address
First Line : 11000 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-3909
Country : US
Telephone Number : 219-750-9389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 05/19/2020

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