Sissay Z Anberber, MD
Individual provider Active NPI Pediatrics Physician · Geneva, IL
NPI 1467613638 · NPPES record last updated May 20, 2020
Key facts
- NPI
- 1467613638
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 036-121409 (IL)
- Practice address
- 2800 Keslinger Rd Ste 160
Geneva, IL 60134-3753 - Phone
- (630) 232-7200
- Fax
- (630) 232-2288
- NPI assigned
- Jun 20, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120214000893 | IL | Practitioner - Pediatric Medicine | 5395903710 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-121409 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Pediatrics | Current |
Accepting new patients |
| Central Dupage Physician Group | Current |
Accepting new patients | |
| Genesis Health System | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
2800 Keslinger Rd
Ste 160
Geneva, IL 60134
Phone (630) 232-7200
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-121409 | IL | Yes |
Addresses
Primary practice location
2800 Keslinger Rd Ste 160
Geneva, IL 60134-3753
Mailing address
2800 Keslinger Rd Ste 160
Geneva, IL 60134-3753
Phone (630) 232-7200
Other names
- Dr. Sissay A Zeleke
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.