Individual provider Active NPI

Abdul Sattar, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1598710014
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036045353 Issued in IL
Practice address
4646 N Marine Dr
Suite # C6500
Chicago, IL 60640
Phone
(773) 728-4655
Fax
(773) 728-1176
NPI assigned
May 23, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036045353 IL Primary

Addresses

Primary practice location

4646 N Marine Dr
Suite # C6500
Chicago, IL 60640

Mailing address

4646 N Marine Dr
Ste # C 6500
Chicago, IL 60640-5759
Phone (773) 728-4655

Other identifiers 1

IdentifierTypeStateIssuer
036045353MedicaidIL

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
I20080724000077 IL Practitioner - Internal MedicinePractitioner - Endocrinology 5193898161 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036045353ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abdul Sattar MD SC Internal Medicine CurrentSince May 14, 2008 Accepting new patients
Skyline Physicians LLC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

1512 W Fargo Ave
Chicago, IL 60626
Phone (773) 465-7751

4646 N Marine Dr
Ste C
Chicago, IL 60640
Phone (773) 564-5344

4646 N Marine Dr
Ste C6500
Chicago, IL 60640
Phone (773) 728-4655

1200 Roosevelt Rd
Ste 140
Glen Ellyn, IL 60137
Phone (708) 307-2103

Organizations & group practices 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1598710014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "address_2": "STE # C 6500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-728-4655",
            "fax_number": "773-728-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "address_2": "SUITE # C6500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-728-4655",
            "fax_number": "773-728-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTAR",
        "first_name": "ABDUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036045353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036045353",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.