Otangeles Medical Of Illinois, INC.
Internal Medicine in Bloomington, IL. Organization (NPI-2).
NPI number1023934643
StatusActive
Last updated in NPPESJun 26, 2026
Details
- NPI
- 1023934643
- Entity type
- Organization (NPI-2)
- Legal business name
- Otangeles Medical Of Illinois, INC.
- Organization subpart
- No
- Enumeration date
- Jun 26, 2026
- Certification date
- Jun 27, 2026
- Last updated
- Jun 26, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
8 Derby WayBloomington, IL 61704-2820
Phone 219-256-6002
Mailing address
8 Derby WayBloomington, IL 61704-2820
Phone 219-256-6002
Authorized official
Dionne C Okafor
President
2192566002
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