Love, Terry Wayne

Love, Terry Wayne is an individual health care provider with primary practice located at 645 W Main St , Ottawa IL 61350-2717. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Love, Terry Wayne can be contacted via phone (815) 434-1977.

Contact Information

Primary practice address
645 W Main St Ottawa IL 61350-2717
Phone: (815) 434-1977
Fax: (815) 434-2022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036052926 Illinois

Profile Details

NPI number 1124034459
LBN Legal business name Love, Terry Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Feb 2nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124034459 NPPES
Illinois Other P01428101 PALMETTO GBA
Illinois MEDICAID 36052926 PALMETTO GBA

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