Individual provider Active NPI

Sara Boblick Smith, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1306069471
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301083568 Issued in MI
Practice address
840 S Wood St
Division of General Pediatrics (MC 856)
Chicago, IL 60612-4325
Phone
(312) 996-7184
Fax
(312) 413-0243
NPI assigned
Apr 10, 2007
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301083568 MI
Internal Medicine Physician 207R00000X 4301083568 MI
Pediatrics Physician 208000000X 4301083568 MI Primary

Addresses

Primary practice location

840 S Wood St
Division of General Pediatrics (MC 856)
Chicago, IL 60612-4325

Mailing address

840 S Wood St
Division of General Pediatrics (MC 856)
Chicago, IL 60612-4325
Phone (312) 996-7184

Other names 1

  • Sara Shelby Boblick Former name

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
I20111109000371 IL Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4587729488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Northwestern University Feinberg Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

840 S Wood St
Chicago, IL 60612-4325

840 S Wood St 130 CSN
Uic Pathology
Chicago, IL 60612-4325
Phone (312) 996-7313

840 S Wood St MC
Chicago, IL 60612-4325

845 W Wilson Ave
Uic Medicine
Chicago, IL 60640-8090
Phone (312) 744-1295

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301083568MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 2, 2011 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Aug 2, 2011 Accepting new patients
Cook County Internal Medicine CurrentSince May 19, 2022 Accepting new patients
Cook County CurrentSince May 19, 2022 Accepting new patients

Locations

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

7732 Solutions Ctr
Chicago, IL 60677

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

Interoperability endpoints

  • Direct secure messaging: ssmith17488@uihealth.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1306069471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "DIVISION OF GENERAL PEDIATRICS (MC 856)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-7184",
            "fax_number": "312-413-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "DIVISION OF GENERAL PEDIATRICS (MC 856)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-7184",
            "fax_number": "312-413-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SARA",
        "middle_name": "BOBLICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301083568",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301083568",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301083568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "BOBLICK",
            "middle_name": "SHELBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.