Active NPI
Sana A Attar, M.D
- Pediatrics Physician
- Libertyville, IL
National Provider Identifier
1316927759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036048638
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036048638 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036048638 | IL | MD | Pediatric Allergy/Immunology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
dba Pediatric and Allergy Associates
- Pediatrics Physician
- Libertyville, IL
- NPI 1245491851
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.