Individual provider Active NPI

Sarah Clark

  • Family Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1063120855
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
PENDING Issued in IL
Practice address
4607 Fesseneva CT
Naperville, IL 60564-5835
Phone
(331) 980-2677
NPI assigned
Nov 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X PENDING IL Primary

Addresses

Primary practice location

4607 Fesseneva CT
Naperville, IL 60564-5835

Mailing address

4607 Fesseneva CT
Naperville, IL 60564-5835
Phone (331) 980-2677

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
I20230721003204 IL Practitioner - Nurse Practitioner 8921473356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

600 W Adams St
Chicago, IL 60661-3604
Phone (312) 506-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGILMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Jan 1, 2025 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince May 28, 2023 Accepting new patients

Locations

600 W Adams St
Chicago, IL 60661
Phone (312) 506-0900

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1063120855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 FESSENEVA CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645835",
            "telephone_number": "331-980-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 FESSENEVA CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645835",
            "telephone_number": "331-980-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SARAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.