Individual provider Active NPI

Omar Danny Katib, M.D.

  • Diagnostic Radiology Physician
  • Park Ridge, IL
National Provider Identifier
1477816619
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-142701 Issued in IL
Practice address
1775 Dempster St
Park Ridge, IL 60068-1143
Phone
(847) 723-5016
Fax
(847) 723-9800
NPI assigned
Jun 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-142701 IL Primary
Diagnostic Radiology Physician 2085R0202X 01098110A IN
Diagnostic Radiology Physician 2085R0202X 4301100754 MI

Addresses

Primary practice location

1775 Dempster St
Park Ridge, IL 60068-1143

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 237-9203

Other practice location 2

1420 Renaissance Drive
Suite 307
Park Ridge, IL 60068-1343
Phone (847) 803-1000

Other practice location 3

430 Warrenville Rd Ste 110
Lisle, IL 60532-1348
Phone (630) 946-2020

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address okatib250973@direct.myadvocateaurora.org Direct
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address okatib307656@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20180905003037 IL Practitioner - Diagnostic Radiology 7113277591 Reassigns benefits to 2 organizations
I20251029000236 IN Practitioner - Diagnostic Radiology 7113277591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-142701ILMDDiagnostic Radiology Physician
01098110AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic, LLC CurrentSince Oct 9, 2025 Accepting new patients
The South Bend Clinic LLC CurrentSince Oct 9, 2025 Accepting new patients
Dupage Medical Group LTD CurrentSince Oct 6, 2025 Accepting new patients
Dupage Medical Group LTD CurrentSince Oct 6, 2025 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

430 Warrenville Rd
Ste 110
Lisle, IL 60532
Phone (630) 946-2020

430 Warrenville Rd
Ste 210
Lisle, IL 60532
Phone (630) 432-6180

301 E Day Rd
Mishawaka, IN 46545
Phone (574) 204-7300

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1477816619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-5016",
            "fax_number": "847-723-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 N Eddy St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466172808",
            "country_code": "US",
            "telephone_number": "574-237-9203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 RENAISSANCE DRIVE",
            "address_2": "Suite 307",
            "address_purpose": "LOCATION",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681343",
            "country_code": "US",
            "telephone_number": "847-803-1000",
            "fax_number": "847-803-1098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 Warrenville Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Lisle",
            "state": "IL",
            "postal_code": "605321348",
            "country_code": "US",
            "telephone_number": "630-946-2020",
            "fax_number": "630-432-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATIB",
        "first_name": "OMAR",
        "middle_name": "DANNY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-142701",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01098110A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301100754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okatib250973@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1420 Renaissance Dr Ste 307",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1420 Renaissance Dr Ste 307",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okatib307656@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "430 Warrenville Rd Ste 110",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.