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General NPI Number Information
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NPI Number | 1194285742
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Entity Type | Individual
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Provider Name | JAMIL OLOMI DMD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 4307 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-1815
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Country | US
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Telephone | 773-286-0300
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Fax | 773-286-0340
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Provider Business Mailing Address
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Address Line | 2630 N WASHTENAW AVE APT 2N
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City | CHICAGO
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State | IL
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Zip | 60647-1824
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Country | US
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Telephone | 224-565-7705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.032373
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License Number State | IL
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