Individual provider Active NPI

Peter Kevin Sand, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Skokie, IL
National Provider Identifier
1700984408
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
036064560 Issued in IL
Practice address
9650 Gross Point Rd # 3900
Skokie, IL 60076
Phone
(224) 251-2374
Fax
(847) 933-3531
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 036064560 IL Primary

Addresses

Primary practice location

9650 Gross Point Rd # 3900
Skokie, IL 60076

Mailing address

9650 Gross Point Rd # 3900
Skokie, IL 60076-1214
Phone (224) 251-2374

Other practice location 1

9650 Gross Point Rd # 3900
Skokie, IL 60076
Phone (224) 251-2374

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
I20050831000376 IL Practitioner - Obstetrics/Gynecology 8820020746 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036064560ILMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Mar 1, 1998 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology CurrentSince Mar 1, 1998 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1000 Central St
Ste 730
Evanston, IL 60201
Phone (847) 663-8410

9650 Gross Point Rd
Ste 3900
Skokie, IL 60076
Phone (224) 251-2374

9650 Gross Point Rd
Fl Third
Skokie, IL 60076

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1700984408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD # 3900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761214",
            "telephone_number": "224-251-2374",
            "fax_number": "847-933-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD # 3900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "224-251-2374",
            "fax_number": "847-933-3531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9650 Gross Point Rd # 3900",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "60076",
            "country_code": "US",
            "telephone_number": "224-251-2374",
            "fax_number": "847-570-1386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAND",
        "first_name": "PETER",
        "middle_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "IL",
            "license": "036064560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.