Sophie Nyambal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6500 W 65TH St
Chicago, IL 60638-4962

Phone

(708) 496-1515

NPI assigned

Feb 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• American Current Care of Illinois PC

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1285071241

  IL

  Medicare reassignment NPD
• Hicksville Family Medical Care, PLLC

  • Family Medicine Physician
  • Mineola, NY
  • NPI 1770813792
  Medicare reassignment
• Statcare Urgent & Walk in Medical Care PLLC

  • Urgent Care Clinic/Center
  • Mineola, NY
  • NPI 1336426667
  NPD (past)

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1659819449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 W 65TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606384962",
            "telephone_number": "708-496-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 W 65TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606384962",
            "telephone_number": "708-496-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAMBAL",
        "first_name": "SOPHIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin B Nwiado
• Catherine B Nwileh-Ibeagha
• Chidinma Nwokocha, APRN-BC,C
• Ogechi Nwosu Hickman, MD
• NXT LVL PT Inc
• Diane M Nyari, APN
• Victoria L Nyberg, LPC
• Thomas Nye, DPT
• Sharmilee M Nyenhuis, M.D.
• Douglas Nyenke, APRN, PMHNP-BC

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.