Organization
OMNI PRIMARY CARE AND AESTHETIC MEDICINE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUWARIA OSMANI SIDDIQUI M.D (DOCTOR)
(847) 242-1001
Entity
Organization
Contact information
Practice address
6501 N LINCOLN AVE, LINCOLNWOOD, IL 60712-3925
(847) 242-1001
(847) 739-7219
Mailing address
6501 N LINCOLN AVE, LINCOLNWOOD, IL 60712-3925
(847) 242-1001
(847) 739-7219
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
036122637
IL
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036122637
—
IL
Enumeration date
09/11/2012
Last updated
11/07/2024
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