Organization
OMNI HEALTH PC
Active
Other names
Lincoln Square Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZAKI SIDDIQUI M.D (M.D)
(773) 989-3344
Entity
Organization
Contact information
Practice address
2501 W LAWRENCE AVE, SUITE C, CHICAGO, IL 60625-2958
(773) 989-3344
(773) 989-8458
Mailing address
2501 W LAWRENCE AVE, SUITE C, CHICAGO, IL 60625-2958
(773) 989-3344
(773) 989-8458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036122637
IL
208000000X
Pediatrics Physician
Primary
036100955
IL
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
036126888
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100955
—
IL
Enumeration date
11/04/2011
Last updated
11/04/2011
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