Provider Demographics
NPI:1255487641
Name:OMNI HEALTH.P.C
Entity type:Organization
Organization Name:OMNI HEALTH.P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-989-3344
Mailing Address - Street 1:2501 W LAWRENCE AVE
Mailing Address - Street 2:UNIT# C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2958
Mailing Address - Country:US
Mailing Address - Phone:773-989-3344
Mailing Address - Fax:773-989-8458
Practice Address - Street 1:2501 W LAWRENCE AVE
Practice Address - Street 2:UNIT# C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2958
Practice Address - Country:US
Practice Address - Phone:773-989-3344
Practice Address - Fax:773-989-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty