Moreno, Omar

Moreno, Omar is an sole proprietor health care provider with primary practice located at 1441 S 61St Ct , Cicero IL 60804-1049. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Moreno, Omar can be contacted via phone (224) 432-9196.

Contact Information

Primary practice address
1441 S 61St Ct Cicero IL 60804-1049
Phone: (224) 432-9196
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1982150140
LBN Legal business name Moreno, Omar
Credentials LCP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2016
Last updated Aug 28th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1982150140 NPPES
Illinois MEDICAID 199960618

Popular Providers