Individual provider Active NPI

Sarina Dimaso, PEER SUPPORT SPECIAL

  • Peer Specialist
  • Chicago, IL
National Provider Identifier
1235843392
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
4320 W Montrose Ave
Chicago, IL 60641-2016
Phone
(773) 883-9100
Fax
(773) 883-0005
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

4320 W Montrose Ave
Chicago, IL 60641-2016

Mailing address

4320 W Montrose Ave
Chicago, IL 60641-2016
Phone (177) 388-3910

Other practice location 1

4326 W Montrose Ave
Chicago, IL 60641-2016
Phone (773) 883-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1235843392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412016",
            "telephone_number": "177-388-3910",
            "fax_number": "773-883-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412016",
            "telephone_number": "773-883-9100",
            "fax_number": "773-883-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4326 W Montrose Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606412016",
            "country_code": "US",
            "telephone_number": "773-883-9100",
            "fax_number": "773-883-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMASO",
        "first_name": "SARINA",
        "credential": "PEER SUPPORT SPECIAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.