Individual provider Active NPI

Nadrine Sinead Omar, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1902253248
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012968 Issued in IL
Practice address
2740 W Foster Ave Ste 313
Chicago, IL 60625-3524
Phone
(773) 271-3344
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012968 IL Primary

Addresses

Primary practice location

2740 W Foster Ave Ste 313
Chicago, IL 60625-3524

Mailing address

6542 N Kenneth Ave
Lincolnwood, IL 60712-3354
Phone (847) 309-3194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160826001442 IL Practitioner - Chiropractic 0143515312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Wellness LLCGroup PAC ID 3072752864, 21 clinicians

Practice addresses (Care Compare)

4555 N Lincoln Ave
Chicago, IL 60625-2102
Phone (847) 791-7012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012968ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roque-Ponton Medical Group, S.C. PastSince Mar 15, 2006 Accepting new patients
Active Wellness, LLC Chiropractor Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1902253248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6542 N KENNETH AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123354",
            "telephone_number": "847-309-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 313",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253524",
            "telephone_number": "773-271-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMAR",
        "first_name": "NADRINE",
        "middle_name": "SINEAD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.