Healthcare Provider Details

I. General information

NPI: 1992058333
Provider Name (Legal Business Name): OMAR MARWAN HAMOUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W DIVISION ST STE 100
CHICAGO IL
60622-3093
US

IV. Provider business mailing address

229 PARK AVE
CLARENDON HILLS IL
60514-1372
US

V. Phone/Fax

Practice location:
  • Phone: 773-326-2244
  • Fax:
Mailing address:
  • Phone: 904-909-1801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number036155258
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036155258
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME109404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: