Individual
OMMAR T HLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 W US ROUTE 6, MORRIS, IL 60450
(815) 364-8915
(815) 941-0743
Mailing address
725 SCHOOL ST STE A, MORRIS, IL 60450-1207
(815) 941-9124
(815) 941-4363
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036091671
IL
2085R0001X
Radiation Oncology Physician
G158948
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503203
ANTHEM
IN
05
—
036091671 1
—
IL
01
—
09919437
JOHA BCBS
IL
01
—
209405012
MEDICARE-COOK NOMC
IL
01
—
214143
LUDAG-JOLIET
IL
01
—
214152
LUDAG-KANKAKEE
IL
01
—
749640013
MEDICARE-WILL NOSC
IL
01
—
8232230
BLUE CROSS BLUE SHIELD
IL
01
—
K31484
MEDICARE JOLIET
IL
01
—
K33087
MEDICARE-KANKAKEE
IL
01
—
K48414
MEDICARE INDIV ID# FOR GROUP 336140
IL
01
—
P00348399
RAIL ROAD MEDICARE
IL
Enumeration date
07/13/2006
Last updated
11/03/2021
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