Individual provider Active NPI

Sara Elizabeth Jandeska, M.D.

  • Pediatric Nephrology Physician
  • Chicago, IL
National Provider Identifier
1316146392
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
3611473 Issued in IL
Practice address
2300 N Childrens PLZ
Chicago, IL 60614-3363
Phone
(773) 327-5023
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-111733 IL
Pediatric Nephrology Physician 2080P0210X 3611473 IL Primary

Addresses

Primary practice location

2300 N Childrens PLZ
Chicago, IL 60614-3363

Mailing address

124 Frank Lloyd Wright LN
Oak Park, IL 60302-2643
Phone (702) 358-1421

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjandeska@direct.ccprovider.org Direct Cook County

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
I20080219000109 IL Practitioner - Pediatric MedicinePractitioner - Nephrology 9133202872 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111733ILMDPediatrics Physician
3611473ILMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Nov 23, 2010 Accepting new patients
Cook County Pediatrics CurrentSince Nov 23, 2010 Accepting new patients
Cook County Current Accepting new patients
Rush University Medical Group Pediatrics CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

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

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

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1653 W Congress Pkwy
#622
Chicago, IL 60612
Phone (312) 942-5068

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 710
Chicago, IL 60612
Phone (312) 942-5983

Interoperability endpoints

  • Direct secure messaging: sjandeska10206@direct.rush.rush-health.com
  • Direct secure messaging: sjandeska@direct.ccprovider.org

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1316146392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 FRANK LLOYD WRIGHT LN",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022643",
            "telephone_number": "702-358-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N CHILDRENS PLZ",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-327-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDESKA",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-111733",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": "3611473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjandeska@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.