Provider Demographics
NPI:1487660486
Name:SAWLANI, OMPRAKASH D (MD)
Entity Type:Individual
Prefix:DR
First Name:OMPRAKASH
Middle Name:D
Last Name:SAWLANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4400 W 95TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2654
Mailing Address - Country:US
Mailing Address - Phone:708-425-2880
Mailing Address - Fax:708-425-0609
Practice Address - Street 1:4400 W 95TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2654
Practice Address - Country:US
Practice Address - Phone:708-425-2880
Practice Address - Fax:708-425-0609
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036057974208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036057974Medicaid