Individual provider Active NPI

Bruce E Sands, M.D.

  • Specialist
  • Waukegan, IL
National Provider Identifier
1073611190
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-4023
Fax
(847) 360-4221
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

11588 14TH Ave
Pleasant Prairie, WI 53158-4521
Phone (847) 436-0270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191008001395 CA Practitioner - Emergency Medicine 9436120227 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of California, a Medical Corporation Current Accepting new patients
New Era Medical Services, LLC Past Accepting new patients
Midwest Emergency Department Specialists LTD Past Accepting new patients
Midway Emergency Physicians, LLC Past Accepting new patients
City of Hope Medical Group of Illinois PLLC Specialist Past Accepting new patients

Locations

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073611190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11588 14TH AVE",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531584521",
            "telephone_number": "847-436-0270",
            "fax_number": "262-948-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-4023",
            "fax_number": "847-360-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDS",
        "first_name": "BRUCE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.