Individual provider Active NPI

Christina Ann Skaar, PA

  • Physician Assistant
  • Lisle, IL
National Provider Identifier
1720479405
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006473 Issued in IL
Practice address
805 Ogden Ave
Lisle, IL 60532-1337
Phone
(630) 903-1759
Fax
(708) 398-6870
NPI assigned
Feb 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9108423 FL
Physician Assistant 363A00000X 085006473 IL Primary

Addresses

Primary practice location

805 Ogden Ave
Lisle, IL 60532-1337

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 2

IdentifierTypeStateIssuer
Y0Q65OtherFLBCBS
IC071ZOtherFLMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cskaar235882@direct.edward.org

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
I20180416001590 IL Practitioner - Physician Assistant 8628395142 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9108423FLMDPhysician Assistant
085006473ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Nov 1, 2021 Accepting new patients
HSHS Medical Group Inc CurrentSince Apr 23, 2018 Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Dupage Medical Group LTD CurrentSince Nov 1, 2021 Accepting new patients
Memorial Physician Services Physician Assistant CurrentSince Jul 10, 2023 Accepting new patients
Memorial Physician Services CurrentSince Jul 10, 2023 Accepting new patients
SJL Health Systems Inc CurrentSince Apr 23, 2018 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Memorial Expresscare, LLC Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

4455 E US Route 36
Decatur, IL 62521
Phone (217) 876-5320

901 W Morton Ave
Ste 22
Jacksonville, IL 62650
Phone (217) 588-6140

805 Ogden Ave
Lisle, IL 60532
Phone (331) 903-1759

1836 S MacArthur Blvd
Springfield, IL 62704
Phone (217) 789-1403

3132 Old Jacksonville Rd
Ste 110
Springfield, IL 62704
Phone (217) 588-2600

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 11

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": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1720479405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 OGDEN AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321337",
            "telephone_number": "630-903-1759",
            "fax_number": "708-398-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAAR",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108423",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0Q65",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IC071Z",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cskaar235882@direct.edward.org",
            "affiliation": "N",
            "address_1": "805 Ogden Ave",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.