MEDICARE: MICHAEL HENRY OSTER D.O.

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	207P00000X	Emergency Medicine Physician	39679-021	WI
2	207P00000X	Emergency Medicine Physician		IL

General Provider Information

NPI Number	:	1356333991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HENRY OSTER D.O.

Provider Business Mailing Address
First Line	:	34555 N RED OAK LN
Second Line	:
City	:	GURNEE
State	:	IL
Zip	:	60031-2563
Country	:	US
Telephone Number	:	847-244-0678
Fax Number	:	847-244-0886

Provider Business Practice Location Address
First Line	:	34555 N RED OAK LN
Second Line	:
City	:	GURNEE
State	:	IL
Zip	:	60031-2563
Country	:	US
Telephone Number	:	847-244-0678
Fax Number	:	847-244-0886

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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