Individual provider Active NPI

Ellen C Omi, MD

  • Trauma Surgery Physician
  • Oak Lawn, IL
National Provider Identifier
1487689816
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
036114622 Issued in IL
Practice address
4400 W 95TH St
Oak Lawn, IL 60453-2654
Phone
(708) 684-8000
NPI assigned
Jul 12, 2006
Last updated
Nov 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036114622 IL
Surgical Critical Care Physician 2086S0102X 036114622 IL
Trauma Surgery Physician 2086S0127X 036114622 IL Primary

Addresses

Primary practice location

4400 W 95TH St
Oak Lawn, IL 60453-2654

Mailing address

4400 W 95TH St
Oak Lawn, IL 60453-2654
Phone (708) 684-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061127000321 IL Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 2365440484 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, shared by 39 NPIs, 3,081 clinicians

Practice addresses (Care Compare)

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Sep 5, 2012 Accepting new patients
The Board of Trustees of the University of Illinois Surgery CurrentSince Sep 5, 2012 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 7, 2009 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Dec 7, 2009 Accepting new patients
Advocate Health & Hospitals Corporation Current Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

1801 W Taylor St
#3F
Chicago, IL 60612
Phone (312) 355-4300

28592 Network Pl
Chicago, IL 60673

29373 Network Pl
Chicago, IL 60673

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

4440 W 95th St
Ste Aip
Oak Lawn, IL 60453
Phone (708) 684-8000

10811 W 143rd St
Ste 100
Orland Park, IL 60467
Phone (708) 460-2500

Interoperability endpoints

  • Direct secure messaging: eomi206133@direct.myadvocateaurora.org

Organizations & group practices 9

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1487689816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654",
            "telephone_number": "708-684-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654",
            "telephone_number": "708-684-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMI",
        "first_name": "ELLEN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036114622",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036114622",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036114622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.