Individual provider Active NPI

Deborah Michelle Sontag

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1104012855
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209006758 Issued in IL
Practice address
1600 Dodge Ave
Evanston, IL 60201-3449
Phone
(847) 424-7265
Fax
(847) 492-5809
NPI assigned
Sep 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209006758 IL
Nurse Practitioner 363L00000X 209006758 IL Primary

Addresses

Primary practice location

1600 Dodge Ave
Evanston, IL 60201-3449

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

2750 W North Ave
Chicago, IL 60647-5247
Phone (312) 666-3494

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
I20071220000397 IL Practitioner - Nurse Practitioner 7012007586 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209006758ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc Current Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Nov 24, 2025 Accepting new patients
Erie Family Health Center Inc CurrentSince Aug 25, 2018 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 18, 2025 Accepting new patients
Erie Family Health Center, Inc CurrentSince Aug 25, 2018 Accepting new patients

Locations

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

251 E Huron St
Chicago, IL 60611

2750 W North Ave
Chicago, IL 60647
Phone (312) 432-2767

9532 Eagle Way
Chicago, IL 60678

1600 Dodge Ave
Evanston, IL 60201
Phone (847) 424-7000

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

Interoperability endpoints

  • Direct secure messaging: dsontag368176@direct.ochin.org

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": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1104012855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DODGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013449",
            "telephone_number": "847-424-7265",
            "fax_number": "847-492-5809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606475247",
            "country_code": "US",
            "telephone_number": "312-666-3494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONTAG",
        "first_name": "DEBORAH",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006758",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.