OMOVAUDO DIVINE OMO-EBOH MD
NPI 1164154878
Family Medicine in Chicago, IL

Q: What is Omovaudo Omo-eboh's NPI number?

The NPI number for Omovaudo Omo-eboh is 1164154878. It was assigned to this individual provider in the NPPES registry on June 30, 2022. The provider is also known as Fatima Ogar-Egbor.

Q: What is Omovaudo Omo-eboh's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Omovaudo Omo-eboh was last updated on June 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 30, 2022PECOS Enrolled

1625 E 75TH ST, CHICAGO, IL 60649(773) 947-7313 Get Directions Write a Review

NPPES record last updated: June 30, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Omovaudo Divine Omo-eboh Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMOVAUDO DIVINE OMO-EBOH MD (NPI 1164154878) is an individual family medicine provider in Chicago, Illinois, licensed in Illinois (125.081017) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1164154878

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameOMOVAUDO DIVINE OMO-EBOHCredential: MD

Location Address1625 E 75TH STChicago, IL 60649-3603

Mailing Address1625 E 75th StChicago, IL 60649-3603 · (773) 947-7313

Phone(773) 947-7313

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJune 30, 2022

NPPES CertifiedJune 30, 2022

✔ NPI 1164154878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 125.081017

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1625 E 75TH ST, Chicago, IL 60649

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Other Names 1

Former Name (1)Fatima Ogar-egbor

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omovaudo Divine Omo-eboh Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921569021

PECOS Enrollment IDI20260917004060

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60649 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THAW HAN MD

Family Medicine

1625 E 75TH ST
CHICAGO, IL 60649

Cook County (773) 947-7310

RUKSANA S NAZNEEN M. D.

Family Medicine

1625 E 75TH ST
CHICAGO, IL 60649

Cook County (773) 947-7310

FRIEDELL CLINIC, S. C.

Family Medicine

1625 E 75TH ST
CHICAGO, IL 60649

Cook County (773) 947-2828

DR. LAKSHMI DODDA M. D.

Family Medicine

1625 E 75TH ST, FIRST FLOOR
CHICAGO, IL 60649

Cook County (773) 947-7314

GAZI MOIN AHMED SHAIK MD

Family Medicine

1625 E 75TH ST
CHICAGO, IL 60649

Cook County (773) 947-7310

DR. USMAN IQBAL KHAN M.D.

Family Medicine

1625 E 75TH ST
CHICAGO, IL 60649

Cook County (773) 947-7313

SHIRLEY MONTGOMERY M.D.

Pediatrics

1625 E 75TH ST, FIRST FLOOR
CHICAGO, IL 60649

Cook County (773) 947-7500

MUZZAMIL HUSSAIN SHAIK

Family Medicine

1625 E 75TH ST
CHICAGO, IL 60649

Cook County (773) 947-7310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omovaudo Omo-eboh's NPI number?

The NPI number for Omovaudo Omo-eboh is 1164154878. It was assigned to this individual provider in the NPPES registry on June 30, 2022. The provider is also known as Fatima Ogar-Egbor.

Where is Omovaudo Omo-eboh located?

Omovaudo Omo-eboh practices at 1625 E 75th St, Chicago, IL 60649. The listed phone number is (773) 947-7313.

What is Omovaudo Omo-eboh's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Omovaudo Omo-eboh enrolled in Medicare?

Yes. Omovaudo Omo-eboh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Omovaudo Omo-eboh was last updated on June 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.