Individual provider Active NPI

Cia-Mattae Saunsiderae Sevier, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1578665808
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-119-418 Issued in IL
Practice address
3223 W 63Rd St
Chicago, IL 60629-3333
Phone
(773) 768-5000
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-119-418 IL Primary

Addresses

Primary practice location

3223 W 63Rd St
Chicago, IL 60629-3333

Mailing address

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other identifiers 1

IdentifierTypeStateIssuer
036119418MedicaidIL

Other names 1

  • Cia-Mattae Saunsiderae Sevier 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
I20110325000881 IL Practitioner - Family Practice 5698743979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

680 N Lake Shire Dr
Suite 1000
Chicago, IL 60611-8709

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-119-418ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 17, 2016 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Sep 1, 2015 Accepting new patients
Community Health Partnership of Illinois CurrentSince Mar 19, 2013 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 17, 2016 Accepting new patients
Community Health Partnership of Illinois Current Accepting new patients
Community Health Partnership of Illinois CurrentSince Mar 19, 2013 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 1, 2015 Accepting new patients

Locations

157 S Lincoln Ave
Ste D
Aurora, IL 60505
Phone (630) 859-0015

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

Dept 5777
Carol Stream, IL 60122

9831 S Western Ave
Chicago, IL 60643
Phone (773) 445-3500

205 W Randolph St
Ste 2222
Chicago, IL 60606
Phone (312) 795-0000

680 N Lake Shore Dr
Ste 810
Chicago, IL 60611
Phone (312) 926-8811

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

29373 Network Pl
Chicago, IL 60673

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 8

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1578665808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000",
            "fax_number": "773-778-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606293333",
            "telephone_number": "773-768-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVIER",
        "first_name": "CIA-MATTAE",
        "middle_name": "SAUNSIDERAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-119-418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119418",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CIA-MATTAE",
            "last_name": "SEVIER",
            "middle_name": "SAUNSIDERAE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.