Individual provider Active NPI

Diana Barros, CSA

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1720225469
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
08-211 Issued in IL
Practice address
4211 N Cicero Ave
Suite #200
Chicago, IL 60641-1651
Phone
(773) 545-6900
Fax
(773) 545-2220
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 08-211 IL Primary

Addresses

Primary practice location

4211 N Cicero Ave
Suite #200
Chicago, IL 60641-1651

Mailing address

4211 N Cicero Ave
Suite #200
Chicago, IL 60641-1651
Phone (773) 545-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08-211ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bone and Joint Center PC Past Accepting new patients

Organizations & group practices 1

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1720225469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE",
            "address_2": "SUITE #200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411651",
            "telephone_number": "773-545-6900",
            "fax_number": "773-545-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE",
            "address_2": "SUITE #200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411651",
            "telephone_number": "773-545-6900",
            "fax_number": "773-545-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARROS",
        "first_name": "DIANA",
        "credential": "CSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "08-211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.