MEDICARE: DALYA OMAR DNP, FNP

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	363LF0000X	Family Nurse Practitioner	209.030855	IL

General Provider Information

NPI Number	:	1255155628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALYA OMAR DNP, FNP

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:	773-784-1025
Fax Number	:

Provider Business Practice Location Address
First Line	:	2553 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4019
Country	:	US
Telephone Number	:	773-784-1025
Fax Number	:

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

Provider Enumeration Date	:	11/13/2024
Last Update Date	:	06/17/2026

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