Sandra Marie Borgstrom

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.007798 Issued in IL

Practice address

240 S 5TH Ave
St Charles, IL 60174-2905

Phone

(630) 377-1414

NPI assigned

Nov 23, 2021

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1427715523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 FAIRCHILD LN",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601856165",
            "telephone_number": "630-639-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 5TH AVE",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742905",
            "telephone_number": "630-377-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGSTROM",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.007798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charia Monique Bolden, CNA
• Bon DDS Dental Studio PC
• Rona Bongat, COTA/L
• Julie E Bonhotal, SLP
• Ellen Jean Bonine, OTRL
• Jessica Aman Borst, APRN, CNP
• Sharmistha Bose, PHD
• Alyson Leigh Boze
• Timothy Michael Bradley, MD
• Daniel J Brady, D.D.S.

• Clinical Social Worker in St Charles, IL
• Providers in St Charles, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.