Individual provider Active NPI

Sara Huezo Funes, M.D

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1225279979
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S3911 Issued in TX
Practice address
4235 W North Ave
Chicago, IL 60639-4852
Phone
(773) 278-6868
Fax
(773) 278-6922
NPI assigned
Mar 10, 2009
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.127338 IL
Family Medicine Physician 207Q00000X S3911 TX Primary

Addresses

Primary practice location

4235 W North Ave
Chicago, IL 60639-4852

Mailing address

4530 W University Dr
Prosper, TX 75078-9090
Phone (469) 607-7504

Other identifiers 1

IdentifierTypeStateIssuer
036.127338MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210726001186 TX Practitioner - Family Practice 1557533668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.127338ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Physicians, PLLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2310 W University Dr
#1500
Denton, TX 76201
Phone (940) 220-5901

104 S Main St
Keller, TX 76248
Phone (214) 295-9385

4530 W University Dr
Prosper, TX 75078
Phone (469) 607-7504

377 W Campbell Rd
Ste 100
Richardson, TX 75080
Phone (469) 232-2945

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1225279979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789090",
            "telephone_number": "469-607-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606394852",
            "telephone_number": "773-278-6868",
            "fax_number": "773-278-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEZO FUNES",
        "first_name": "SARA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.127338",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036.127338",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.