Individual provider Active NPI

Qian Sun

  • Physician Assistant
  • North Aurora, IL
National Provider Identifier
1275163248
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008121 Issued in IL
Practice address
1213 Oak St
North Aurora, IL 60542-2006
Phone
(630) 504-2200
NPI assigned
Jan 18, 2020
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008121 IL Primary

Addresses

Primary practice location

1213 Oak St
North Aurora, IL 60542-2006

Mailing address

1213 Oak St
North Aurora, IL 60542-2006
Phone (630) 504-2200

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
I20220719001184 IL Practitioner - Physician Assistant 6901287382 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.008121ILMDPhysician Assistant

Organizations & group practices 2

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": "1579305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1275163248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 OAK ST",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605422006",
            "telephone_number": "630-504-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 OAK ST",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605422006",
            "telephone_number": "630-504-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "QIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-18",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Aurora, IL

Sources for this page

Verify at the official NPI Registry.