Individual provider Active NPI

Sissay Z Anberber, MD

  • Pediatrics Physician
  • Geneva, IL
National Provider Identifier
1467613638
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-121409 Issued in 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
Last updated
May 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-121409 IL Primary

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 1

  • Dr. Sissay A Zeleke Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000893 IL Practitioner - Pediatric Medicine 5395903710 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-121409ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Pediatrics CurrentSince Apr 8, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Apr 8, 2020 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

2800 Keslinger Rd
Ste 160
Geneva, IL 60134
Phone (630) 232-7200

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1467613638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 KESLINGER RD STE 160",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343753",
            "telephone_number": "630-232-7200",
            "fax_number": "630-232-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 KESLINGER RD STE 160",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343753",
            "telephone_number": "630-232-7200",
            "fax_number": "630-232-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANBERBER",
        "first_name": "SISSAY",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-121409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SISSAY",
            "last_name": "ZELEKE",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.