Soha Omar Bauomy Abotaleb, DO
Individual provider Active NPI Family Medicine Physician · Gurnee, IL
NPI 1043968670 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1043968670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036177556 (IL)
- Practice address
- 15 Tower CT
Gurnee, IL 60031-3336 - Phone
- (847) 599-8899
- Fax
- (847) 599-8897
- NPI assigned
- Mar 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2650 Ridge Ave
Suite 1223
Evanston, IL 60201-1797
4901 Searle Pkwy
Suite 150
Skokie, IL 60077-5320
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- sabotaleb1888537@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036177556 | IL | Yes |
Addresses
Primary practice location
15 Tower CT
Gurnee, IL 60031-3336
Mailing address
2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040
Other providers in Gurnee, IL
- Roseviminda Abano
- Cynthia Yvonne Abban
- Russul Abbas
- Jamil Abdur-Rahman
- Linda Obeng Aboagye
- Jeevan Chechakunnil Abraham
- Elina Abugov
- Abundance Care and Wellness, LLC
- Accelerated Rehabilitation Center of Kenosha LTD
- Accelerated Rehabilitation Centers of Kenosha LTD
All providers in Gurnee, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.