Individual provider Active NPI

Latifa Omran

  • Technician/Technologist
  • Urbana, IL
National Provider Identifier
1417419045
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Technician/TechnologistTaxonomy code 156F00000X
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

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.