Omar Dalloul, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036088845 Issued in IL

Practice address

1860 W Winchester Rd
Ste 107
Libertyville, IL 60048-5312

Phone

(847) 247-1010

Fax

(847) 247-1011

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Lake Villa Dialysis Dialysis facility, Lake Villa, IL, CCN 142666
• DaVita Lake County Dialysis Services Dialysis facility, Vernon Hills, IL, CCN 142552
• DaVita Beach Park Dialysis Dialysis facility, Waukegan, IL, CCN 142864
• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
• Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kidney Health Center LLC

  • Nephrology Physician
  • Libertyville, IL
  • NPI 1225848435
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Botkins Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Waukegan, IL
  • NPI 1134787864

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Vernon Hills, IL
  • NPI 1265401475

  Dialysis facility

  Care Compare affiliation Name & address match
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation
• Northwestern Lake Forest Hospital

  • General Acute Care Hospital
  • Lake Forest, IL
  • NPI 1124025176
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1336197367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD",
            "address_2": "STE 107",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485312",
            "telephone_number": "847-247-1010",
            "fax_number": "847-247-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD",
            "address_2": "STE 107",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485312",
            "telephone_number": "847-247-1010",
            "fax_number": "847-247-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLOUL",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036088845",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036088845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Cassandra Cwiklinski, MA, LMFT
• Jessica Lynn Czajka, PT
• Lisa D'Andrea, PA-C
• Josephine J Dabhi, DDS DENTIST
• Brian E Dagel, CRNA
• Joseph Dalton, PA-C
• Robert Paul Dambrosio, DO
• Erin Danahy, LCSW
• Brian Patrick Danielewicz, D.D.S.
• Holden Danielewicz, DMD

• Nephrology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.