MEDICARE: REBEKAH OSGOOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	036132078	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	125055889	OTHER	IL	TEMPORARY LICENSE NUMBER

General Provider Information

NPI Number	:	1013146596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH OSGOOD M.D.

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 810
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8700
Country	:	US
Telephone Number	:	312-926-3627
Fax Number	:	312-587-9802

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 810
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8700
Country	:	US
Telephone Number	:	312-926-3627
Fax Number	:	312-587-9802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2009
Last Update Date	:	10/22/2018

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Directions to “ REBEKAH OSGOOD M.D.” Practice Location

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