Individual
DR. OMAR HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
675 W NORTH AVE, SUITE 214, MELROSE PARK, IL 60160-1634
(708) 450-4557
(708) 338-0200
Mailing address
7607 MADISON ST, FOREST PARK, IL 60130-3513
(708) 450-4557
(708) 338-0200
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
36111662
IL
207RP1001X
Pulmonary Disease Physician
Primary
36111662
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
36111662
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31601838
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/19/2006
Last updated
10/15/2011
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