Individual provider Active NPI

Omar Azem, MD

  • Radiation Oncology Physician
  • Chicago, IL
National Provider Identifier
1134708902
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
125079611 Issued in IL
Practice address
500 S Paulina St Ste 13
Chicago, IL 60612-3804
Phone
(312) 942-5751
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Radiation Oncology Physician 2085R0001X 125079611 IL Primary

Addresses

Primary practice location

500 S Paulina St Ste 13
Chicago, IL 60612-3804

Mailing address

500 S Paulina St Ste 13
Chicago, IL 60612-3804
Phone (312) 942-5751

Other practice location 1

55 Arch St Ste 1B
Akron, OH 44304-1436
Phone (330) 375-3315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125079611ILMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1134708902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S PAULINA ST STE 13",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123804",
            "telephone_number": "312-942-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S PAULINA ST STE 13",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123804",
            "telephone_number": "312-942-5751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Arch St Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443041436",
            "country_code": "US",
            "telephone_number": "330-375-3315",
            "fax_number": "330-375-7779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZEM",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "125079611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.