MEDICARE: OSARETIN ORONSAYE 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	036-097639	IL

General Provider Information

NPI Number	:	1093701575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSARETIN ORONSAYE M.D.

Provider Business Mailing Address
First Line	:	2653 W OGDEN AVE
Second Line	:	SUITE 3B
City	:	CHICAGO
State	:	IL
Zip	:	60608-1647
Country	:	US
Telephone Number	:	773-522-6100
Fax Number	:	773-257-2527

Provider Business Practice Location Address
First Line	:	2653 W OGDEN AVE
Second Line	:	SUITE 3B
City	:	CHICAGO
State	:	IL
Zip	:	60608-1647
Country	:	US
Telephone Number	:	773-522-6100
Fax Number	:	773-257-2527

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	04/22/2019

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