Healthcare Provider Details

I. General information

NPI: 1285164509
Provider Name (Legal Business Name): BETTER QUALITY OF LIFE CARE MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8334 BEECH AVE
MUNSTER IN
46321-1440
US

IV. Provider business mailing address

8334 BEECH AVE
MUNSTER IN
46321-1440
US

V. Phone/Fax

Practice location:
  • Phone: 312-933-0661
  • Fax:
Mailing address:
  • Phone: 312-933-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. OLUSOLA AKINTUNDE OLOWE
Title or Position: DIRECTOR
Credential: MD
Phone: 312-933-0661