Omni Diagnostic Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OMNI DIAGNOSTIC LABORATORY INC

Practice address

5866 N Lincoln Ave Ste 103
Chicago, IL 60659-4632

Phone

(773) 574-8743

NPI assigned

Mar 15, 2023

Organization subpart

No

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

Authorized official

Name

Mohammed Azheruddin

Title

Authorized Official

Phone

(773) 943-2487

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Omni Diagnostic Laboratory Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Omni Laboratory Services

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1063991735
  NPD tax ID

Locations

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1154022200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5866 N LINCOLN AVE STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5866 N LINCOLN AVE STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594632",
            "telephone_number": "773-574-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI DIAGNOSTIC LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "AZHERUDDIN",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "773-943-2487"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha Omer
• Danah Omer, MD
• Azra Omerovic, M.D.
• Omolola Nicole Ometoruwa
• Kathleen M Omnes, DPT
• Omni Health PC
• Omni Health.P.C
• Omni Laboratory Services
• Omni Wound Physicians Il, PLLC
• Omnipotent Care Hospice

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.