Provider Demographics
NPI:1902253248
Name:OMAR, NADRINE SINEAD (DC)
Entity Type:Individual
Prefix:DR
First Name:NADRINE
Middle Name:SINEAD
Last Name:OMAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6542 N KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3354
Mailing Address - Country:US
Mailing Address - Phone:847-309-3194
Mailing Address - Fax:
Practice Address - Street 1:2740 W FOSTER AVE STE 313
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3524
Practice Address - Country:US
Practice Address - Phone:773-271-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor