Individual provider Active NPI

Elizabeth J Sanchez, ANP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1457893661
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.015100 Issued in IL
Practice address
2331 W Chicago Ave
Chicago, IL 60622-4723
Phone
(773) 772-7858
Fax
(773) 276-6668
NPI assigned
Nov 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.015100 IL Primary

Addresses

Primary practice location

2331 W Chicago Ave
Chicago, IL 60622-4723

Mailing address

PO Box 3603
Oak Brook, IL 60522-3603

Other identifiers 2

IdentifierTypeStateIssuer
13936022OtherILCAQH
209-015100MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170227001674 IL Practitioner - Nurse Practitioner 2769766351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivek Gupta, M.D., S.C.Group PAC ID 3678668308, 28 clinicians

Practice addresses (Care Compare)

2720 W Division St
Chicago, IL 60622-2853
Phone (773) 772-7858

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.015100ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vivek Gupta, M.D., S.C. CurrentSince Jan 1, 2017 Accepting new patients

Locations

2720 W Division St
Chicago, IL 60622
Phone (773) 523-8600

2331 W Chicago Ave
Chicago, IL 60622
Phone (773) 772-7858

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1457893661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3603",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605223603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224723",
            "telephone_number": "773-772-7858",
            "fax_number": "773-276-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13936022",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209-015100",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.