Dr O MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DR O MD LLC

Practice address

7828 S Hoyne Ave
Chicago, IL 60620-5741

Phone

(480) 770-3967

NPI assigned

Feb 18, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Omar L Dominique, MDNPI 1770996050

Title

President

Phone

(480) 770-3967

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Omar L Dominique, M.D.

  • Hospitalist Physician
  • Gilbert, AZ
  • NPI 1770996050

  Family Medicine

  NPD Authorized official

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1649803719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7828 S HOYNE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205741",
            "telephone_number": "480-770-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7828 S HOYNE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205741",
            "telephone_number": "480-770-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR O MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "DOMINIQUE",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-770-3967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.