Healthcare Provider Details

I. General information

NPI: 1962142661
Provider Name (Legal Business Name): REMMY SYLVESTER OWOR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 TAMARACK RD
NEWARK OH
43055-2303
US

IV. Provider business mailing address

2900 N LAKE SHORE DR
CHICAGO IL
60657-5640
US

V. Phone/Fax

Practice location:
  • Phone: 614-339-2000
  • Fax:
Mailing address:
  • Phone: 240-898-6795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.004192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: