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Amanda Demet Osta

Internal Medicine

Allopathic & Osteopathic Physicians

1801 W Taylor St Suite 2e, Chicago, IL 60612

PECOS Enrollment

This provider is enrolled in PECOS as AMANDA OSTA.

Based on the most recent information from CMS, provider Amanda Demet Osta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1437281391
Provider Type
Individual
Full Name
Osta, Amanda Demet
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/9/2007
Last Updated
4/25/2013

Contact Information

Practice Location

1801 W Taylor St Suite 2e, Chicago, IL 60612

(312) 996-7416

Unlisted Fax

Mailing Location

840 S. Wood, Mc 856, Chicago, IL 60612

Unlisted Phone

(312) 413-0243

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 036121394 Illinois
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 4301082432 Michigan
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License 4301082432 Michigan
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License 036121394 Illinois

Amanda Demet Osta

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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