# OMNI PRIMARY CARE AND AESTHETIC MEDICINE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699025239
- **Authorized official:** DR. JUWARIA OSMANI SIDDIQUI M.D (DOCTOR)
- **Authorized official phone:** (847) 242-1001

## Contact information

- **Practice address:** 6501 N LINCOLN AVE, LINCOLNWOOD, IL 60712-3925
- **Practice address phone:** (847) 242-1001
- **Practice address fax:** (847) 739-7219
- **Mailing address:** 6501 N LINCOLN AVE, LINCOLNWOOD, IL 60712-3925
- **Mailing address phone:** (847) 242-1001
- **Mailing address fax:** (847) 739-7219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | 036122637 | IL | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 09/11/2012
- **Last updated:** 11/07/2024