Omni Primary Care and Aesthetic Medicine SC

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

036122637 Issued in IL

Legal business name

OMNI PRIMARY CARE AND AESTHETIC MEDICINE SC

Practice address

6501 N Lincoln Ave
Lincolnwood, IL 60712-3925

Phone

(847) 242-1001

Fax

(847) 739-7219

NPI assigned

Sep 11, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Juwaria Osmani Siddiqui, M.DNPI 1003063264

Title

Doctor

Phone

(847) 242-1001

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Juwaria O Siddiqui, M.D

  • Family Medicine Physician
  • Lincolnwood, IL
  • NPI 1003063264
  Medicare reassignment Care Compare group Authorized official
• Ishrat Osman, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1992711808
  Medicare reassignment Care Compare group NPD
• Samia Irfani, M.D.

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1437326907
  NPD (past)
• Jeana Manaay Lang, M.D.

  • Pediatrics Physician
  • Lincolnwood, IL
  • NPI 1821318049
  NPD (past)

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1699025239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123925",
            "telephone_number": "847-242-1001",
            "fax_number": "847-739-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123925",
            "telephone_number": "847-242-1001",
            "fax_number": "847-739-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI PRIMARY CARE AND AESTHETIC MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "JUWARIA",
        "authorized_official_middle_name": "OSMANI",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "847-242-1001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036122637",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036122637",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Ockrim
• Onyinye Ijemma Odumegwu-Ojukwu
• Luca Senam Oh, D.C.
• Christopher Michael Olesen, PTA
• Omni Health PC
• One Step Clinical Services Inc
• Onsite Durable Medical Equipment Inc.
• Onsite Health Ancillary Services
• Onsite Health Specialty Physicians, Inc
• Onsite Health Therapies, LLC

• Adolescent Medicine (Family Medicine) Physician in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Adolescent Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.