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Organization
SAJI OOMMEN MD SC
Active
Organization
SAJI OOMMEN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAJI OOMMEN MD (MD)
(847) 866-7221
Entity
Organization
Contact information
Practice address
1101 HOWARD ST STE 202, EVANSTON, IL 60202-3878
(847) 866-7221
Mailing address
1101 HOWARD ST STE 202, EVANSTON, IL 60202-3878
(847) 866-7221
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036088920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
539220
MEDICARE PTAN
IL
Enumeration date
01/06/2010
Last updated
01/06/2010
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