NPIMap

Organization Active NPI

Oral and Maxilloficial Head and Neck Associates LLC

Doing business as Omhna

  • Otolaryngology Physician
  • Oak Lawn, IL
National Provider Identifier
1821652736
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ORAL AND MAXILLOFICIAL HEAD AND NECK ASSOCIATES LLC
Doing business as
Omhna
Oral Cancer Institute
Practice address
4400 W 95TH St Ste 113
Oak Lawn, IL 60453-2655
Phone
(773) 245-5253
Fax
(773) 295-1026
NPI assigned
Apr 25, 2019
Last updated
Oct 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Authorized official

Name
Mohammed K Qaisi, MD FACSNPI 1679783088
Title
Managing Partner
Phone
(318) 547-2825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4400 W 95TH St Ste 113
Oak Lawn, IL 60453-2655

Mailing address

PO Box 734471
Chicago, IL 60673-4471
Phone (773) 245-5253

Other practice location 1

3000 N Halsted St
Chicago, IL 60657-5188
Phone (773) 245-5253

Other names 2

  • OMHNA Doing business as
  • Oral Cancer Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190613000700 IL Part B Supplier - Clinic/Group Practice 1951634500 Receives reassigned benefits from 8 practitioners
Practice locations: Chicago, IL; Oak Lawn, IL

National Provider Directory

National Provider Directory

Locations

811 W Wellington Ave
Chicago, IL 60657
Phone (773) 871-1461

913 W Wellington Ave
Fl 1
Chicago, IL 60657
Phone (773) 871-1461

4400 W 95th St
Ste 113
Oak Lawn, IL 60453
Phone (773) 245-5253

4440 W 95th St
Ste 113
Oak Lawn, IL 60453
Phone (773) 296-7645

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1821652736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734471",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734471",
            "telephone_number": "773-245-5253",
            "fax_number": "773-295-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 113",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532655",
            "telephone_number": "773-245-5253",
            "fax_number": "773-295-1026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 N Halsted St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575188",
            "country_code": "US",
            "telephone_number": "773-245-5253",
            "fax_number": "773-295-1026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFICIAL HEAD AND NECK ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "QAISI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "318-547-2825",
        "authorized_official_credential": "MD FACS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMHNA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oral Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.