Sandra Marie Nirva, MA, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.004444 Issued in IL

Practice address

500 W Elk Grove Blvd
Elk Grove Village, IL 60007-4272

Phone

(847) 525-8500

NPI assigned

Aug 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336663285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MEADOW LN",
            "city": "OAKWOOD HILLS",
            "state": "IL",
            "postal_code": "600131148",
            "telephone_number": "847-525-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W ELK GROVE BLVD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600074272",
            "telephone_number": "847-525-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 Elk Grove Town Ctr",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600073754",
            "country_code": "US",
            "telephone_number": "847-290-1111",
            "fax_number": "847-290-1065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIRVA",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "credential": "MA, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.004444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.