Individual provider Active NPI

Albert Sebandal, NP

  • Primary Care Nurse Practitioner
  • Wheeling, IL
National Provider Identifier
1134823354
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209027026 Issued in IL
Practice address
1823 Cardinal CT
Wheeling, IL 60090-7141
Phone
(765) 490-5642
NPI assigned
Mar 30, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 209027026 IL Primary

Addresses

Primary practice location

1823 Cardinal CT
Wheeling, IL 60090-7141

Mailing address

1823 Cardinal CT
Wheeling, IL 60090-7141
Phone (765) 490-5642

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
I20230424002092 IL Practitioner - Nurse Practitioner 1658736822 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integra Healthcare SCGroup PAC ID 0042539173, 15 clinicians

Practice addresses (Care Compare)

2504 Washington St
Waukegan, IL 60085-4983
Phone (847) 623-7590

Hospital & facility affiliations

  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209027026ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP Single Specialty CurrentSince Dec 17, 2024 Accepting new patients
Integra Healthcare SC Single Specialty CurrentSince Dec 27, 2023 Accepting new patients
Top Medical Consultants PC Single Specialty CurrentSince Apr 1, 2023 Accepting new patients

Locations

4655 W Chase Ave
Lincolnwood, IL 60712
Phone 8472623800202

2504 Washington St
Waukegan, IL 60085
Phone (847) 336-2288

2534 Elim Ave
Zion, IL 60099
Phone (847) 328-6503

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1134823354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 CARDINAL CT",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600907141",
            "telephone_number": "765-490-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 CARDINAL CT",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600907141",
            "telephone_number": "765-490-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBANDAL",
        "first_name": "ALBERT",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209027026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

Sources for this page

Verify at the official NPI Registry.