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NPI Code Detail

MEDICARE: MICHAEL O'MARA D.O.

MEDICARE: MICHAEL O'MARA D.O.
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
1207P00000XEmergency Medicine Physician036-057007IL

General Provider Information

NPI Number : 1366426710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL O'MARA D.O.
Provider Business Mailing Address
First Line : PO BOX 42898
Second Line :
City : EVERGREEN PARK
State : IL
Zip : 60805-0898
Country : US
Telephone Number : 708-422-4221
Fax Number : 708-422-4415
Provider Business Practice Location Address
First Line : 2800 W 95TH ST
Second Line :
City : EVERGREEN PARK
State : IL
Zip : 60805-2746
Country : US
Telephone Number : 708-422-4221
Fax Number : 708-422-4415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 03/14/2017

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Directions to “ MICHAEL O'MARA D.O.” Practice Location

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