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General NPI Number Information
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NPI Number | 1891699328
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Entity Type | Organization
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Legal Business Name | OFA LLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 4700 W 95TH ST STE 306
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City | OAK LAWN
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State | IL
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Zip | 60453-2572
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Country | US
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Telephone | 708-424-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 W 95TH ST STE 306
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City | OAK LAWN
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State | IL
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Zip | 60453-2572
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. STEVEN GELSOMINO
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Credential | DPM
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Telephone | 708-424-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | NULL
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