Individual provider Active NPI

Rosario M Sandoval

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1629662929
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209022592 Issued in IL
Practice address
2653 W Ogden Ave FL 2
Chicago, IL 60608-1647
Phone
(773) 257-6672
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.022592 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209022592 IL Primary

Addresses

Primary practice location

2653 W Ogden Ave FL 2
Chicago, IL 60608-1647

Mailing address

26460 Network PL
Chicago, IL 60673-1264
Phone (773) 257-6672

Other practice location 1

26460 Network Pl
Chicago, IL 60673-1264
Phone (773) 257-6672

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
I20210427002212 IL Practitioner - Nurse Practitioner 5092123299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians

Practice addresses (Care Compare)

1401 S California Ave
Chicago, IL 60608-1858
Phone (773) 522-6656

2653 W Ogden Ave
FL 3 Suite a
Chicago, IL 60608-1647
Phone (773) 257-6672

2701 W 68TH St
Chicago, IL 60629-1813
Phone (773) 884-9000

California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000

Hospital & facility affiliations

  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
71.53
Promoting interoperability
100
Improvement activities
40
Cost
76.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209022592ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Dec 25, 2020 Accepting new patients
Mount Sinai Community Foundation CurrentSince Dec 25, 2020 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients

Locations

2640 Network Pl
Chicago, IL 60673

2653 W Ogden Ave
Fl 2
Chicago, IL 60608
Phone (773) 257-5300

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1629662929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731264",
            "telephone_number": "773-257-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 W OGDEN AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081647",
            "telephone_number": "773-257-6672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26460 Network Pl",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606731264",
            "country_code": "US",
            "telephone_number": "773-257-6672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "ROSARIO",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.022592",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209022592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.