Ignacio Omengan

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

036101370 Issued in IL

Legal business name

IGNACIO OMENGAN

Practice address

461 N Mulford Rd
Suite #10
Rockford, IL 61107-5190

Phone

(815) 394-1930

Fax

(815) 395-1064

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Ignacio Uy Omengan, M.D., F.A.A.P.NPI 1912911785

Title

Doctor/Owner

Phone

(815) 394-1930

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ignacio U Omengan, MD FAAP

  • Pediatrics Physician
  • Rockford, IL
  • NPI 1912911785
  NPD (past) Authorized official

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1689848541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 N MULFORD RD",
            "address_2": "SUITE #10",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075190",
            "telephone_number": "815-394-1930",
            "fax_number": "815-395-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 N MULFORD RD",
            "address_2": "SUITE #10",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075190",
            "telephone_number": "815-394-1930",
            "fax_number": "815-395-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNACIO OMENGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "OMENGAN",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_middle_name": "UY",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "815-394-1930",
        "authorized_official_credential": "M.D., F.A.A.P."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036101370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel R. Ianno, D.D.S.
• Rukayatu Ibrahim, MD
• Sandy Sameh Aguib Zaki Ibrahim, M.D
• Iconic Nurse Network Outreach, Inc (Iconic Health Academy)
• Ideal Dental Care PC
• Ihc-Swedishamerican Emergency Physicians, LLC
• Steven O Ikenberry, M.D.
• Illinois Department of Human Services
• Illinois Mentor
• Illinois Pathologist Services, LLC

• Pediatric Adolescent Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Pediatric Adolescent Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.