Sara K Zidlicky, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003137 Issued in IL

Practice address

290 Springfield Dr
Suite 290
Bloomingdale, IL 60108-2214

Phone

(630) 893-9660

Fax

(630) 893-9668

NPI assigned

Nov 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1306026935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 290",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-893-9660",
            "fax_number": "630-893-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 SPRINGFIELD DR",
            "address_2": "SUITE 290",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082214",
            "telephone_number": "630-893-9660",
            "fax_number": "630-893-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIDLICKY",
        "first_name": "SARA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "085003137",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400175927",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "920540",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenifer Zagal
• Julie Ann Zakutansky, DC
• Yasmeen Zehra
• Herbert Martin Zerth III, M.D.
• Alex Zevan III, DC, FIACA, DABCI
• Nicholas J Zoretic, DO

• Physician Assistant in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.