Anna Sagan-Blausius, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-101434 Issued in IL

Practice address

4321 S Pulaski Road
Chicago, IL 60632

Phone

(773) 585-2410

Fax

(773) 284-0913

NPI assigned

Jun 28, 2005

Reactivated

Mar 22, 2006

Last updated

Mar 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: asaganblasuis29119@ce-direct.presencehealth.org

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.

• Emergency Care Physician Services HP, LTD.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1104841774
  NPD (past)
• Mercy Community Pharmacy at Oakwood Shores

  • Community/Retail Pharmacy
  • Chicago, IL
  • NPI 1952745937
  NPD (past)
• Mercy Hospital &Medical Center

  dba Mercy Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1215914791

  Family Medicine

  NPD (past)
• Presence Healthcare Services

  dba Presence Medical Group

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1093780181
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1285631838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 S PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-585-2410",
            "fax_number": "773-284-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 S PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-585-2410",
            "fax_number": "773-284-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2233 W Division St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606228151",
            "country_code": "US",
            "telephone_number": "312-770-2128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAGAN-BLAUSIUS",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-101434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE",
            "identifier": "036-101434",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALPRACTICE IN",
            "identifier": "41851",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0713711",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BNDD",
            "identifier": "BS-6689890",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101434",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asaganblasuis29119@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "2233 W Division St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606228151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hasan Hunaid Safiuddin
• Safiudin Aliu (Rockford Medical Imaging)
• Julie Safranski, LCSW
• Safth LLC
• Andrew Safyer, PH.D., LCSW
• Andrew Sagan, M.D.
• Dominika Sagan
• Michelle Lee Sagan, M.D.
• Ruth Sharon Saganty
• Sage & Soul Therapy and Consulting

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.