Individual provider Active NPI

Sarah E Davis, CNP

  • Acute Care Nurse Practitioner
  • McHenry, IL
National Provider Identifier
1730515172
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209010892 Issued in IL
Practice address
4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417
Phone
(815) 455-2752
Fax
(815) 455-2789
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041344050 IL
Nurse Practitioner 363L00000X 209010892 IL
Acute Care Nurse Practitioner 363LA2100X 209010892 IL Primary

Addresses

Primary practice location

4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417

Mailing address

4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417
Phone (815) 455-2752

Other practice location 1

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (224) 654-0000

Other practice location 2

3701 Doty Rd
Woodstock, IL 60098-7509
Phone (815) 338-2500

Other practice location 3

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000

Other identifiers 1

IdentifierTypeStateIssuer
209010892OtherILSTATE LICENSE

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
I20140528002161 IL Practitioner - Nurse Practitioner 6608099247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4874

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

4309 W Medical Ctr Dr
Suite A201
McHenry, IL 60050-8411
Phone (815) 759-8070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041344050ILMDRegistered Nurse
209010892ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

260 E Congress Pkwy
Ste D
Crystal Lake, IL 60014
Phone (815) 759-6363

10370 Haligus Rd
Ste 201
Huntley, IL 60142
Phone (815) 356-5200

10350 Haligus Rd
Ste 200A
Huntley, IL 60142
Phone (847) 669-3880

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

4309 W Medical Center Dr
Ste B202
McHenry, IL 60050
Phone (815) 344-3900

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

3701 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1730515172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B202",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508417",
            "telephone_number": "815-455-2752",
            "fax_number": "815-455-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B202",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508417",
            "telephone_number": "815-455-2752",
            "fax_number": "815-455-2789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "224-654-0000",
            "fax_number": "815-455-2789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3701 Doty Rd",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600987509",
            "country_code": "US",
            "telephone_number": "815-338-2500",
            "fax_number": "815-455-2789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "815-344-5000",
            "fax_number": "815-455-2789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041344050",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209010892",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209010892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209010892",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.