Active NPI
Latifa Omran
- Technician/Technologist
- Urbana, IL
National Provider Identifier
1417419045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- Practice address
- 1400 W Park St
Urbana, IL 61801-2334 - Phone
- (217) 337-2322
- NPI assigned
- Apr 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician/Technologist | 156F00000X | Primary |
Addresses
Primary practice location
1400 W Park St
Urbana, IL 61801-2334
Mailing address
3103 Sandhill LN
Champaign, IL 61822-6180
Phone (217) 721-5278
Other practice location 1
555 W Court St
Kankakee, IL 60901-3664
Phone (815) 937-5521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554163200000",
"number": "1417419045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 SANDHILL LN",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618226180",
"telephone_number": "217-721-5278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012334",
"telephone_number": "217-337-2322"
}
],
"practiceLocations": [
{
"address_1": "555 W Court St",
"address_purpose": "LOCATION",
"city": "Kankakee",
"state": "IL",
"postal_code": "609013664",
"country_code": "US",
"telephone_number": "815-937-5521",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OMRAN",
"first_name": "LATIFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-02",
"last_updated": "2019-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.