Individual
TINCY OOMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 N MICHIGAN AVE STE 1200, CHICAGO, IL 60601-7605
(312) 263-4625
(312) 263-5029
Mailing address
150 N MICHIGAN AVE STE 1200, CHICAGO, IL 60601-7605
(312) 263-4625
(312) 263-5029
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007491
IL
363AM0700X
Medical Physician Assistant
5601008311
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601008311
LICENSE
MI
Enumeration date
02/14/2018
Last updated
06/23/2020
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