Individual provider Active NPI

Garry Sigman, MD

  • Pediatric Adolescent Medicine Physician
  • Maywood, IL
National Provider Identifier
1275507279
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
36066265 Issued in IL
Practice address
2160 S First Ave
(Maguire Center, RM. 3307)
Maywood, IL 60153
Phone
(708) 216-4403
Fax
(708) 216-3375
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 36066265 IL Primary

Addresses

Primary practice location

2160 S First Ave
(Maguire Center, RM. 3307)
Maywood, IL 60153

Mailing address

2160 S First Ave
(Maguire Center, RM. 3307)
Maywood, IL 60153
Phone (708) 216-4403

Other identifiers 1

IdentifierTypeStateIssuer
36066265MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36066265ILMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1275507279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(MAGUIRE CENTER, RM. 3307)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-4403",
            "fax_number": "708-216-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(MAGUIRE CENTER, RM. 3307)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-4403",
            "fax_number": "708-216-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGMAN",
        "first_name": "GARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "36066265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36066265",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.