Individual provider Active NPI

Courtney Sabry, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1639719834
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.007494 Issued in IL
Practice address
1801 W Taylor St Ste 2a
Chicago, IL 60612-4795
Phone
(708) 921-9855
NPI assigned
Jan 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.007494 IL Primary

Addresses

Primary practice location

1801 W Taylor St Ste 2a
Chicago, IL 60612-4795

Mailing address

1130 S Michigan Ave Apt 2116
Chicago, IL 60605-2320
Phone (708) 921-9855

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
I20200326000372 IL Practitioner - Physician Assistant 8729417712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rush Medical College of Rush University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

350 N Wall St 4TH Floor
Kankakee, IL 60901-2901
Phone 81593316714592

Hospital & facility affiliations

  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
  • Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.007494ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Mar 16, 2020 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 16, 2020 Accepting new patients
Riverside Health System Current Accepting new patients
Riverside Health System CurrentSince Aug 4, 2025 Accepting new patients

Locations

100 Fitness Dr
Bourbonnais, IL 60914
Phone (815) 936-6515

300 Riverside Dr
Ste 1100
Bourbonnais, IL 60914
Phone (815) 802-3170

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

901 S Wolcott Ave
Chicago, IL 60612
Phone (312) 996-3470

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1801 W Taylor St
Ste 2A
Chicago, IL 60612
Phone (312) 996-1682

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Organizations & group practices 5

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 3

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": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1639719834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S MICHIGAN AVE APT 2116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052320",
            "telephone_number": "708-921-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "708-921-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABRY",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.