| Omni Healthcare | |
|
2720 W Division St Chicago IL 60622-2853 | |
| (773) 523-8600 | |
| (773) 687-9545 |
| Full Name | Omni Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 2720 W Division St, Chicago, Illinois |
| Authorized Official Name and Position | Vivek Gupta (PRESIDENT) |
| Authorized Official Contact | 7737727858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Healthcare Po Box 3603 Oak Brook IL 60522-3603 Ph: (773) 772-7858 | Omni Healthcare 2720 W Division St Chicago IL 60622-2853 Ph: (773) 523-8600 |
| NPI Number | 1033300694 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 08/29/2023 |
| Medicare PECOS PAC ID | 3678668308 |
|---|---|
| Medicare Enrollment ID | O20070926000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033300694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alfonso E Nobleza |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326013236 PECOS PAC ID: 3173411949 Enrollment ID: I20040304001248 |
| Provider Name | Horia O Stamboliu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932155025 PECOS PAC ID: 0941199806 Enrollment ID: I20040311000032 |
| Provider Name | Shakib Sakla Namas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093780926 PECOS PAC ID: 4082689658 Enrollment ID: I20040827000275 |
| Provider Name | Rhonda Y Gans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003830670 PECOS PAC ID: 2961465794 Enrollment ID: I20041111000648 |
| Provider Name | Wilfredo G Dacuycuy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407818545 PECOS PAC ID: 6709844608 Enrollment ID: I20041223000093 |
| Provider Name | Rajesh T Iyengar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821023714 PECOS PAC ID: 3274591821 Enrollment ID: I20041229000208 |
| Provider Name | Wayne C Williamson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699828061 PECOS PAC ID: 3971549544 Enrollment ID: I20050705000897 |
| Provider Name | Bhavana P Vaidya |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437141108 PECOS PAC ID: 2264459767 Enrollment ID: I20051024000964 |
| Provider Name | Americo M Ramos |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912959305 PECOS PAC ID: 7618999327 Enrollment ID: I20051222000069 |
| Provider Name | Vivek Anand Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376632976 PECOS PAC ID: 7113925322 Enrollment ID: I20061127000084 |
| Provider Name | Eileen Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083668750 PECOS PAC ID: 2668485277 Enrollment ID: I20070621000379 |
| Provider Name | Jeffrey A Olson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952374795 PECOS PAC ID: 7719944156 Enrollment ID: I20080926000634 |
| Provider Name | Eric Mizuno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558398388 PECOS PAC ID: 3072639269 Enrollment ID: I20100924000754 |
| Provider Name | Mohtasham M Mohiuddin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518166461 PECOS PAC ID: 5799873550 Enrollment ID: I20110315000239 |
| Provider Name | Prince L Hodogbey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891004404 PECOS PAC ID: 8022276906 Enrollment ID: I20120223000260 |
| Provider Name | Anna A Trotter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700207784 PECOS PAC ID: 2860622990 Enrollment ID: I20140311000555 |
| Provider Name | Anna L Roy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295128098 PECOS PAC ID: 2163740358 Enrollment ID: I20150420001715 |
| Provider Name | Lloyd A Mercado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457749079 PECOS PAC ID: 9830403559 Enrollment ID: I20150807015178 |
| Provider Name | Gaurika Mehra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518213537 PECOS PAC ID: 4880980564 Enrollment ID: I20160906002086 |
| Provider Name | Tamra A Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740733658 PECOS PAC ID: 9335436419 Enrollment ID: I20160919000999 |
| Provider Name | Capri M Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841640711 PECOS PAC ID: 8426336264 Enrollment ID: I20161028000648 |
| Provider Name | Patricia Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730622952 PECOS PAC ID: 5294017166 Enrollment ID: I20170130001119 |
| Provider Name | Elizabeth Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457893661 PECOS PAC ID: 2769766351 Enrollment ID: I20170227001674 |
| Provider Name | Lindsey Sikora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750827671 PECOS PAC ID: 7517241029 Enrollment ID: I20170301001140 |
| Provider Name | Johann R Serag |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487987814 PECOS PAC ID: 5890932172 Enrollment ID: I20170302000426 |
| Provider Name | Cailian Mo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285172643 PECOS PAC ID: 5597040832 Enrollment ID: I20170328002378 |
| Provider Name | Maria Luisa Jabido |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699208736 PECOS PAC ID: 7810273307 Enrollment ID: I20170418001218 |
| Provider Name | Hannah O Ogunyomi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689109043 PECOS PAC ID: 4385921121 Enrollment ID: I20170504002162 |
| Provider Name | Candice Michelle Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528471059 PECOS PAC ID: 6204104888 Enrollment ID: I20170623000090 |
| Provider Name | Valerie Visitacion Mayuga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740697853 PECOS PAC ID: 2163712274 Enrollment ID: I20170627000287 |
| Provider Name | Melissa Murad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467972802 PECOS PAC ID: 8123399771 Enrollment ID: I20170801001272 |
| Provider Name | Priya Sanil Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427571710 PECOS PAC ID: 5890069942 Enrollment ID: I20170928000335 |
| Provider Name | Jeanice D Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407366842 PECOS PAC ID: 7113283367 Enrollment ID: I20171104000095 |
| Provider Name | Nicole M Welnowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548771595 PECOS PAC ID: 5991061657 Enrollment ID: I20171113002417 |
| Provider Name | Uloma Okeke Igba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609312859 PECOS PAC ID: 3971861618 Enrollment ID: I20171229000944 |
| Provider Name | Joseph Olasehinde Olalusi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134633902 PECOS PAC ID: 4486914744 Enrollment ID: I20180205002737 |
| Provider Name | Alexis L Gellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205346053 PECOS PAC ID: 0042570186 Enrollment ID: I20180209000154 |
| Provider Name | Rachel Cheeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053836106 PECOS PAC ID: 0244582088 Enrollment ID: I20181006000004 |
| Provider Name | Michele A Ivanic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316449200 PECOS PAC ID: 4981956224 Enrollment ID: I20181015001200 |
| Provider Name | Pamela Flores Pizarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225594971 PECOS PAC ID: 4789923640 Enrollment ID: I20190312000567 |
| Provider Name | Zimuzo Crystal Onwuekwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356817175 PECOS PAC ID: 3476894452 Enrollment ID: I20190402000723 |
| Provider Name | Lawrence Edo Abah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306305115 PECOS PAC ID: 0143561803 Enrollment ID: I20190405000294 |
| Provider Name | Virgilio A Caramay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508332552 PECOS PAC ID: 6800081209 Enrollment ID: I20190416000495 |
| Provider Name | Kehinde Christiana Fagbemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912465303 PECOS PAC ID: 5698008704 Enrollment ID: I20190605000165 |
| Provider Name | Sharaine James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326522459 PECOS PAC ID: 7517297625 Enrollment ID: I20191002001610 |
| Provider Name | Bohdan Kontsevyy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235392218 PECOS PAC ID: 0547591018 Enrollment ID: I20191015000167 |
| Provider Name | Melissa Nancy Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740830777 PECOS PAC ID: 7810325214 Enrollment ID: I20200318001624 |
| Provider Name | John Sakla |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356874150 PECOS PAC ID: 1951679471 Enrollment ID: I20200904001871 |
| Provider Name | Mara D Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093312001 PECOS PAC ID: 0648681007 Enrollment ID: I20201117000154 |
| Provider Name | Afusat T Olomada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265065312 PECOS PAC ID: 2668885336 Enrollment ID: I20210120000069 |
| Provider Name | Laura Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194336107 PECOS PAC ID: 7719391945 Enrollment ID: I20210131000012 |
| Provider Name | Breanna Lynn Colorina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538745765 PECOS PAC ID: 7618384157 Enrollment ID: I20210329001088 |
| Provider Name | Stephen L Bala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912582339 PECOS PAC ID: 0941600167 Enrollment ID: I20210609002948 |
| Provider Name | Alma Carlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972170363 PECOS PAC ID: 4981004926 Enrollment ID: I20210614002105 |
| Provider Name | Ruby Kapoor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922671924 PECOS PAC ID: 5890191704 Enrollment ID: I20210901000556 |
| Provider Name | Jordan T Gitalan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659943785 PECOS PAC ID: 1254721285 Enrollment ID: I20211207001319 |
| Provider Name | Binita Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699436113 PECOS PAC ID: 6709278013 Enrollment ID: I20220119000668 |
| Provider Name | Ji Na Khananisho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437812203 PECOS PAC ID: 4981098076 Enrollment ID: I20220307002256 |
| Provider Name | Queen Nnenna Aghaji |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518415926 PECOS PAC ID: 4183092950 Enrollment ID: I20221129001321 |
| Provider Name | Lady Margarette Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063110369 PECOS PAC ID: 9335595792 Enrollment ID: I20231023000214 |
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