Ismail Omar Ismail | Bloomington, MN • PECOS Search

Ismail Omar Ismail

Counselor

Behavioral Health & Social Service Providers

1701 American Blvd E Ste 19, Bloomington, MN 55425-1151

PECOS Enrollment

Based on the most recent information from CMS, provider Ismail Omar Ismail does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1528898103
Provider Type
Individual
Full Name
Ismail, Ismail Omar
Gender
Male

Sole Proprietor
No
Enumeration Date
8/7/2024
Last Updated
8/7/2024

Contact Information

Practice Location

1701 American Blvd E Ste 19, Bloomington, MN 55425-1151

(612) 326-6160

Mailing Location

2001 Killebrew Dr Ste 112, Bloomington, MN 55425-1871

(612) 326-6160

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer