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General NPI Number Information
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NPI Number | 1467520700
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Entity Type | Organization
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Legal Business Name | DAVID M OLIGSCHLAEGER DO LLC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 207 S PINE ST SUITE F
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City | SHELBYVILLE
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State | IL
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Zip | 62565-1749
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Country | US
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Telephone | 217-774-7883
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Fax | 217-774-5935
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Provider Business Mailing Address
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Address Line | 207 S PINE ST SUITE F
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City | SHELBYVILLE
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State | IL
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Zip | 62565-1749
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Country | US
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Telephone | 217-774-7883
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Fax | 217-774-5935
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Authorized Official
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Title or Position | OWNER, DOCTOR
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Name | DR. DAVID M OLIGSCHLAEGER
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Credential | DO
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Telephone | 217-774-7883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036099152
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License Number State | IL
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