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General NPI Number Information
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NPI Number | 1710341599
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Entity Type | Individual
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Provider Name | JENNIFER U OBASI MD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1400 PIN OAK DR
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City | CARTERVILLE
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State | IL
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Zip | 62918-1600
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Country | US
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Telephone | 618-985-3333
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Fax | 618-985-1318
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Provider Business Mailing Address
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Address Line | PO BOX 3988
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City | CARBONDALE
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State | IL
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Zip | 62902-3988
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Country | US
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Telephone | 618-457-5200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 036175296
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | ME169014
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 69071-20
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License Number State | WI
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