Individual provider Active NPI

Sajel Elizabeth Nuwamanya, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1558855387
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.170528 Issued in IL
Practice address
3860 W Ogden Ave
Chicago, IL 60623-2460
Phone
(872) 588-3000
Fax
(872) 588-3001
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301504083 MI
Student in an Organized Health Care Education/Training Program 390200000X L.4749 AL
Family Medicine Physician 207Q00000X 036.170528 IL Primary

Addresses

Primary practice location

3860 W Ogden Ave
Chicago, IL 60623-2460

Mailing address

879 N Richmond St
Chicago, IL 60622-4311
Phone (248) 326-4247

Other practice location 1

4525 Iroquois St
Detroit, MI 48214-4505
Phone (248) 326-4247

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
I20241024003538 IL Practitioner - Family Practice 0840628376 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.170528ILMDFamily Medicine Physician
4301504083MIMDFamily Medicine Physician
L.4749ALMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center Current Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 4, 2024 Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 4, 2024 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients

Locations

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

4696 Paysphere Cir
Chicago, IL 60674

Interoperability endpoints

  • Direct secure messaging: snuwamanya721246@direct.ochin.org

Organizations & group practices 4

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1558855387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 N RICHMOND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224311",
            "telephone_number": "248-326-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000",
            "fax_number": "872-588-3001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Iroquois St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482144505",
            "country_code": "US",
            "telephone_number": "248-326-4247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUWAMANYA",
        "first_name": "SAJEL",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301504083",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "L.4749",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.170528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.