Individual provider Active NPI

Sahar Eftekhar, D.O

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1376819565
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036143296 Issued in IL
Practice address
1 E Superior St Ste 306
Chicago, IL 60611-2595
Phone
(312) 754-9404
Fax
(312) 754-9402
NPI assigned
Apr 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 036143296 IL
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 036143296 IL Primary

Addresses

Primary practice location

1 E Superior St Ste 306
Chicago, IL 60611-2595

Mailing address

1 E Superior St
Suite 306
Chicago, IL 60611
Phone (312) 754-9404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170502001087 CA Practitioner - Psychiatry 4486887601 Reassigns benefits to 1 organization
I20171012002203 IL Practitioner - Psychiatry 4486887601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

1 E Superior St
Suite 306
Chicago, IL 60611-2595
Phone (312) 754-9404

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036143296ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC CurrentSince Aug 21, 2017 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Mar 11, 2017 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Mar 11, 2017 Accepting new patients

Locations

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

Organizations & group practices 3

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": "1333238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1376819565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E SUPERIOR ST",
            "address_2": "SUITE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-754-9404",
            "fax_number": "312-754-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E SUPERIOR ST STE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112595",
            "telephone_number": "312-754-9404",
            "fax_number": "312-754-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFTEKHAR",
        "first_name": "SAHAR",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-01",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036143296",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036143296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.