MEDICARE: DR. EIMAN OMER AHMED OSMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019036344	IL

General Provider Information

NPI Number	:	1598641516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EIMAN OMER AHMED OSMAN DDS

Provider Business Mailing Address
First Line	:	400 E SOUTH WATER ST APT 3106
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-4070
Country	:	US
Telephone Number	:	424-535-8707
Fax Number	:

Provider Business Practice Location Address
First Line	:	4721 S KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-3001
Country	:	US
Telephone Number	:	773-847-4444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	08/14/2025

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