Individual provider Active NPI

Soniya A Shah

  • Physician Assistant
  • Crystal Lake, IL
National Provider Identifier
1619586096
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008170 Issued in IL
Practice address
525 E Congress Pkwy Ste 300
Crystal Lake, IL 60014-6258
Phone
(815) 759-9260
Fax
(815) 459-7840
NPI assigned
Jul 30, 2020
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008170 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

525 E Congress Pkwy Ste 300
Crystal Lake, IL 60014-6258

Mailing address

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

Other practice location 1

4885 Hoffman Blvd Ste 400
Hoffman Estates, IL 60192-3727
Phone (847) 255-9697

Other practice location 2

1819 Carew St
Fort Wayne, IN 46805-4705
Phone (260) 665-4100

Electronic endpoints 3

TypeEndpointUseAffiliation
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 sshah42436@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210916001376 IL Practitioner - Physician Assistant 9436556578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Surgical Care Specialists SCGroup PAC ID 7113992918, 11 clinicians

Practice addresses (Care Compare)

4885 Hoffman Blvd
Suite 400
Hoffman Estates, IL 60192-3727
Phone 84725596972668

525 E Congress Pkwy
Suite 350
Crystal Lake, IL 60014-6271
Phone (815) 455-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008170ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Oncology-Hematology Associates, LTD. CurrentSince Dec 14, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 29, 2025 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Nov 29, 2025 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

525 E Congress Pkwy
Ste 300
Crystal Lake, IL 60014
Phone (815) 759-9260

525 E Congress Pkwy
Ste 350
Crystal Lake, IL 60014
Phone (815) 455-7400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1619586096",
    "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",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY STE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146258",
            "telephone_number": "815-759-9260",
            "fax_number": "815-459-7840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4885 Hoffman Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601923727",
            "country_code": "US",
            "telephone_number": "847-255-9697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1819 Carew St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054705",
            "country_code": "US",
            "telephone_number": "260-665-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SONIYA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008170",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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": "525 E Congress Pkwy Ste 300",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah42436@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "525 E Congress Pkwy Ste 300",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.