Individual provider Active NPI

Sacharitha Bowers, MD

  • Dermatology Physician
  • Springfield, IL
National Provider Identifier
1306067533
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036-136349 Issued in IL
Practice address
751 N Rutledge St
Suite 2300
Springfield, IL 62702-4968
Phone
(217) 545-8000
Fax
(217) 545-4485
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036-136349 IL Primary

Addresses

Primary practice location

751 N Rutledge St
Suite 2300
Springfield, IL 62702-4968

Mailing address

PO Box 19644
Springfield, IL 62794-9644
Phone (217) 545-8000

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Other identifiers 1

IdentifierTypeStateIssuer
036136349MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SBOWERS168026@DIRECT.LUHS.ORG Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113000912 IL Practitioner - Dermatology 2567509227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Southern Illinois University School of Medicine, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4920 N Glen Park Place Rd
Peoria, IL 61614-4655

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions109
Removal or shaving of skin growth1-10
Skin biopsy45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 3, 2014 Accepting new patients
Siu Physicians & Surgeons, Inc Dermatology CurrentSince Nov 3, 2014 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Soderstrom Dermatology Center S C CurrentSince Jan 17, 2025 Accepting new patients
Soderstrom Dermatology Center S C Dermatology CurrentSince Jan 17, 2025 Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

410 Maxine Dr
Morton, IL 61550
Phone (309) 263-7546

2100 Jacobssen Dr
Normal, IL 61761
Phone (309) 268-9980

4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

751 N Rutledge St
Ste 2300
Springfield, IL 62702
Phone (217) 545-3821

Interoperability endpoints

  • Direct secure messaging: sbowers@directaddress.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1306067533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19644",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949644",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST",
            "address_2": "SUITE 2300",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "SACHARITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-136349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036136349",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SBOWERS168026@DIRECT.LUHS.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.