Active NPI
Sandra Anderson, MD
- Pediatrics Physician
- Oak Lawn, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036-117093
- Practice address
- 4220 W 95TH St Ste 210
Oak Lawn, IL 60453-2793 - Phone
- (312) 949-4200
- Fax
- (708) 423-1899
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-117093 | IL | Primary |
Addresses
Primary practice location
4220 W 95TH St Ste 210
Oak Lawn, IL 60453-2793
Mailing address
1 N Broadway St
Des Plaines, IL 60016-2335
Phone (847) 298-3150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-117093 | Other | IL | STATE LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sanderson205782@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-117093 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primecare Community Health, Inc. | Current | Accepting new patients | |
| Endeavor Health Medical Group | Pediatrics | Current | Accepting new patients |
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients | |
| Primecare Community Health Inc | Current | Accepting new patients | |
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Primecare Community Health, Inc. | Current | Accepting new patients |
Locations
303 W Lake St
Ste 200
Addison, IL 60101
303 W Lake St
Addison, IL 60101
Phone (331) 221-1705
1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495
9532 Eagle Way
Chicago, IL 60678
1 N Broadway St
Des Plaines, IL 60016
Phone (847) 298-3150
1200 S York St
Ste 2000
Elmhurst, IL 60126
Phone (331) 221-9002
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
Interoperability endpoints
- sanderson277473@direct.edward.org
- sanderson205782@direct.myadvocateaurora.org
Organizations & group practices 7
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.
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
- Family Medicine Physician
- Chicago, IL
- NPI 1558532739
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1891541215
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1225010911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651536000000",
"number": "1669541868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 N BROADWAY ST",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600162335",
"telephone_number": "847-298-3150",
"fax_number": "847-298-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 W 95TH ST STE 210",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532793",
"telephone_number": "312-949-4200",
"fax_number": "708-423-1899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "SANDRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2022-05-03",
"certification_date": "2022-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-117093",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "036-117093",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sanderson205782@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4220 W 95th St Ste 210",
"city": "Oak Lawn",
"state": "IL",
"country_code": "US",
"postal_code": "604532793",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4220 W 95th St Ste 210",
"city": "Oak Lawn",
"state": "IL",
"country_code": "US",
"postal_code": "604532793",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.