Sanwar Boyal, MD
Individual provider Active NPI Family Medicine Physician · Chicago, IL
NPI 1497428692 · NPPES record last updated Sep 11, 2024
Key facts
- NPI
- 1497428692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036168280 (IL)
- Practice address
- 2231 E 95TH St
Chicago, IL 60617-4804 - Phone
- (773) 768-7700
- Fax
- (773) 273-8915
- NPI assigned
- Jul 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|---|
| I20240215004430 | IL | Practitioner - Family Practice | 7719321975 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036168280 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PMR Illinois Holding, LLC | Current |
Accepting new patients | |
| Jencare Neighborhood Medical Center South Chicago, LLC | Current |
Accepting new patients |
Locations
1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760
2231 E 95th St
Chicago, IL 60617
Phone (773) 768-7700
2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036168280 | IL | Yes |
Addresses
Primary practice location
2231 E 95TH St
Chicago, IL 60617-4804
Mailing address
2231 E 95TH St
Chicago, IL 60617-4804
Phone (773) 768-7700
Other providers in Chicago, IL
- Jordaan Boxer
- Wendy Boxer
- Deborah Boxerman
- Boxfinity Healthcare Center Inc
- Lucien George Boyadjian
- Allison Cooper Boyan
- Claudia Boyas
- Anabel Marie Boyce
- Bianca Boyce
- Justin Bennett Boyce
All providers in Chicago, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2024. 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.