DR. MATHEW OOMMEN (NPI# 1588684542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588684542 |
| Entity Type | Individual |
| Full Name | DR. MATHEW OOMMEN |
| Credential | MD SC |
| Practice Address |
6449 S Pulaski Rd Ste# 110 Chicago IL 60629-5148 |
| Practice Telephone | 7735850001 |
| Practice Fax Number | 6309200395 |
| Mailing Telephone | 7735850001 |
| Mailing Fax Number | 6309200395 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 21607634 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467406140 | Mathew Oommen | Urology | 1812 N Mills Ave, Orlando, FL 32803-1834 | 2006-05-19 |
| Street Address |
6449 S PULASKI RD STE# 110 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60629-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396289914 | Shahida Zia Rehman | Clinical Medical Laboratory | 6449 S Pulaski Rd, Suite 108, Chicago, IL 60629-5148 | 2016-12-16 |
| 1114381977 | Mount Sinai Community Foundation | Family Medicine | 6449 S Pulaski Rd, Ste 211, Chicago, IL 60629-5148 | 2016-04-07 |
| 1568754935 | Picc Line Co, Inc | Internal Medicine | 6449 S Pulaski Rd, Chicago, IL 60629-5148 | 2011-05-04 |
| 1154648418 | Ahmed Medical Associates Sc | Anesthesiology | 6449 S Pulaski Rd, Chicago, IL 60629-5148 | 2010-04-27 |
| 1649444910 | Junaid Ahmed Dds, PC | Dentist | 6449 S Pulaski Rd, Chicago, IL 60629-5148 | 2008-04-17 |
| 1154540730 | Mathew Oommen Md Sc | Dermatology | 6449 S Pulaski Rd, Ste#110, Chicago, IL 60629-5148 | 2007-04-24 |
| 1104946623 | Junaid M. Ahmed | Dentist | 6449 S Pulaski Rd, Chicago, IL 60629-5148 | 2007-03-29 |
| 1891833075 | Jolan Fejes | Internal Medicine | 6449 S Pulaski Rd, Suite113, Chicago, IL 60629-5148 | 2007-02-01 |
| 1366516445 | Nasreen A Ahmed | Anesthesiology | 6449 S Pulaski Rd, Chicago, IL 60629 | 2006-11-20 |
| 1265532840 | Norman Dabiri | Dentist | 6449 S Pulaski Rd, Chicago, IL 60629-5148 | 2006-09-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946392 | T & M Care LLC | In Home Supportive Care | 7230 S Talman, Apt 4, Chicago, IL 60629 | 2020-03-06 |
| 1841847811 | Jacqueline Ann Milton | Technician | 6720 South Keating, Chicago, IL 60629 | 2019-08-23 |
| 1194202085 | Andrea Mosqueda | Counselor | 4217 W 59th St, Chicago, IL 60629 | 2018-07-23 |
| 1316439235 | Saliha Awais | Dentist | 5521 S. Kedzie Ave. Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1356833255 | Irfana Ilyas | Dentist | 2403,5521 S Kedzie Ave, Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1871003715 | Siddhi Vinayak Dental | Clinic/Center | 5521 S Kedzie Ave, Unit 105, Chicago, IL 60629 | 2017-10-05 |
| 1477092328 | Debra Shepard | Social Worker | 2601 W. Marquette Rd., Catholic Charities, Chicago, IL 60629 | 2017-02-13 |
| 1255777108 | Jacquelyn Jones | Developmental Therapist | 3108 West Marquette Road Apartment 1-b, Chicago, IL 60629 | 2013-05-20 |
| 1124368030 | Claudia Ballesteros | Interpreter | 5631 S. Richmond, Chicago, IL 60629 | 2013-03-01 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1891257853 | Maria Estela Martinez Escala | Dermatology | 5841 S Maryland Ave Ste Mc5067, Chicago, IL 60637-1443 | 2019-04-01 |
| 1275013450 | Advanced Dermatology and Aesthetic Medicine | Dermatology | 850 S Wabash Ave Ste 200, Chicago, IL 60605-3642 | 2018-08-17 |
| 1346784543 | Dermio, LLC | Dermatology | 3023 N Clark St, Suite 861, Chicago, IL 60657-5200 | 2016-12-07 |
| 1366823544 | Oyinade Aderibigbe | Dermatology | 111 W Washington St Ste 1801, Chicago, IL 60602-3430 | 2015-06-14 |
| 1073909032 | Julia Dai | Dermatology | 5758 S Maryland Ave Fl 3, Chicago, IL 60637 | 2015-04-07 |
| 1437544582 | Nicholas Blickenstaff | Dermatology | 30 N Michigan Ave Ste 1429, Chicago, IL 60602-3698 | 2015-04-04 |
| 1801285929 | Medical Dermatology Associates of Chicago, Ltd | Dermatology | 363 W Erie St, Suite 350, Chicago, IL 60654-6903 | 2015-01-13 |
| 1366857286 | Noor Tazudeen | Dermatology | 4700 N Marine Dr Ste 220, Chicago, IL 60640-7972 | 2014-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.