NPIMap

Individual provider Active NPI

Sean Michael Rardin, M.D.

  • Family Medicine Physician
  • Naperville, IL
National Provider Identifier
1225020076
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-114032 Issued in IL
Practice address
445 Aurora Ave
Naperville, IL 60540-6274
Phone
(630) 355-8844
Fax
(630) 355-8848
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-114032 IL Primary

Addresses

Primary practice location

445 Aurora Ave
Naperville, IL 60540-6274

Mailing address

445 Aurora Ave
Naperville, IL 60540-6274
Phone (630) 355-8844

Other practice location 1

40 75th St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000909 IL Practitioner - Family PracticePractitioner - Emergency Medicine 5890716898 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114032ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley West Community Hospital CurrentSince Apr 1, 2011 Accepting new patients
Midwest Express Care 2, Inc Family Medicine CurrentSince Jul 15, 2021 Accepting new patients
Osf Healthcare System CurrentSince Apr 1, 2014 Accepting new patients
Central Dupage Hospital Association CurrentSince Apr 1, 2014 Accepting new patients
National University of Health Sciences CurrentSince Oct 1, 2010 Accepting new patients
Osf Healthcare System Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jul 15, 2021 Accepting new patients
Central Dupage Hospital Association CurrentSince Apr 1, 2014 Accepting new patients
Valley West Community Hospital CurrentSince Apr 1, 2011 Accepting new patients
Osf Healthcare System CurrentSince Apr 1, 2014 Accepting new patients
Fastrac Medical, P.C. Past Accepting new patients
Red Bud Illinois Hospital Company, LLC Family Medicine Past Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

Dept 4698
Carol Stream, IL 60122

Carol Stream, IL 60122

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

200 E Roosevelt Rd
Lombard, IL 60148
Phone (630) 629-9664

1302 N Main St
Sandwich, IL 60548
Phone (815) 486-8484

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11209/brand/1/csg/1/fhir/r4

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1225020076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 AURORA AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406274",
            "telephone_number": "630-355-8844",
            "fax_number": "630-355-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 AURORA AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406274",
            "telephone_number": "630-355-8844",
            "fax_number": "630-355-8848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 75th St",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605272325",
            "country_code": "US",
            "telephone_number": "630-581-5372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RARDIN",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.