Individual provider Active NPI

Sarah Elizabeth Gonzales Zoeteman, FNP

  • Family Nurse Practitioner
  • Oak Lawn, IL
National Provider Identifier
1508351446
Registry record updated Jun 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.017620 Issued in IL
Practice address
4201 W 95TH St
Oak Lawn, IL 60453-2615
Phone
(708) 636-8546
NPI assigned
Jun 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2018

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 209.017620 IL Primary

Addresses

Primary practice location

4201 W 95TH St
Oak Lawn, IL 60453-2615

Mailing address

1949 Wellington PL
Downers Grove, IL 60516-2470
Phone (630) 947-5420

Other practice location 1

5257 S Cicero Ave
Chicago, IL 60632-4915
Phone (773) 735-8038

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
I20190506001015 IL Practitioner - Nurse Practitioner 7719229103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.017620ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nowobilska Medical Practice LTD CurrentSince Mar 30, 2019 Accepting new patients

Locations

5257 S Cicero Ave
Chicago, IL 60632
Phone (773) 735-8038

4201 W 95th St
Oak Lawn, IL 60453
Phone (708) 636-1466

Interoperability endpoints

  • Direct secure messaging: sgonzaleszoeteman300560@direct.myadvocateaurora.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529712000000",
    "number": "1508351446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 WELLINGTON PL",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162470",
            "telephone_number": "630-947-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532615",
            "telephone_number": "708-636-8546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5257 S Cicero Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606324915",
            "country_code": "US",
            "telephone_number": "773-735-8038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES ZOETEMAN",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2018-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.