Omega Hospice & Palliative Care, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2002590 Issued in IL

Legal business name

OMEGA HOSPICE & PALLIATIVE CARE, LLC

Practice address

1717 Howard St
Evanston, IL 60202-3735

Phone

(847) 425-9089

Fax

(847) 425-9091

NPI assigned

Jun 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edward Lee Oller Jr., R.N.

Title

Administrator

Phone

(847) 425-9089

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063615920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 HOWARD ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023735",
            "telephone_number": "847-425-9089",
            "fax_number": "847-425-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 HOWARD ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023735",
            "telephone_number": "847-425-9089",
            "fax_number": "847-425-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA HOSPICE & PALLIATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-425-9089",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2002590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.