Emmanuel Otuwa

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Practice address

504 Wysteria Dr
Olympia Fields, IL 60461-1228

Phone

(708) 983-9088

NPI assigned

Apr 29, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1881911907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 WYSTERIA DR",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 WYSTERIA DR",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611228",
            "telephone_number": "708-983-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTUWA",
        "first_name": "EMMANUEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olympia Fields Hospital, LLC
• Open Mind Health Wellness
• Open MRI of Olympia Fields, LLC
• Thomas Erastus Ortlieb Jr.
• Faizan Ali Osmani
• Ina Pachwicewicz
• Amanda Michele Pack, PH.D.
• Eva Veronica Page, MD
• Christine Maureen Palicke, APN
• Miranda Palmer, OTD, OTR/L

• Durable Medical Equipment & Medical Supplies in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.