Individual provider Active NPI

Sana A Attar, M.D

  • Pediatrics Physician
  • Libertyville, IL
National Provider Identifier
1316927759
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036048638 Issued in IL
Practice address
1027 W Park Ave
Libertyville, IL 60048-2550
Phone
(847) 367-2615
Fax
(847) 367-1801
NPI assigned
Jan 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 036048638 IL
Pediatrics Physician 208000000X 036048638 IL Primary

Addresses

Primary practice location

1027 W Park Ave
Libertyville, IL 60048-2550

Mailing address

1027 W. Park Ave.
Libertyville, IL 60048
Phone (847) 367-2615

Other identifiers 1

IdentifierTypeStateIssuer
036048638MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036048638ILMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Physician Group Pediatrics Past Accepting new patients

Organizations & group practices 1

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1316927759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 W. PARK AVE.",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-367-2615",
            "fax_number": "847-367-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 W PARK AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482550",
            "telephone_number": "847-367-2615",
            "fax_number": "847-367-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTAR",
        "first_name": "SANA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "IL",
            "license": "036048638",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036048638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048638",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.