Individual provider Active NPI

Alan S Panares

  • Surgical Assistant
  • Hoffman Estates, IL
National Provider Identifier
1760692347
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
238000082 Issued in IL
Practice address
1245 Mallard LN
Hoffman Estates, IL 60192
Phone
(312) 593-0824
Fax
(813) 854-2244
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 246ZC0007X 238000082 IL Primary

Addresses

Primary practice location

1245 Mallard LN
Hoffman Estates, IL 60192

Mailing address

1245 Mallard LN
Hoffman Estates, IL 60192-4507
Phone (312) 593-0824

Other practice location 1

4717 W Pensacola Ave Apt 1N
Chicago, IL 60641-1683
Phone (312) 593-0824

Other identifiers 1

IdentifierTypeStateIssuer
01637103OtherILBLUE CROSS BLUE SHIELD OF IL

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
238000082ILMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1760692347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MALLARD LN",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601924507",
            "telephone_number": "312-593-0824",
            "fax_number": "813-854-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 MALLARD LN",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60192",
            "telephone_number": "312-593-0824",
            "fax_number": "813-854-2244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4717 W Pensacola Ave Apt 1N",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606411683",
            "country_code": "US",
            "telephone_number": "312-593-0824",
            "fax_number": "813-854-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANARES",
        "first_name": "ALAN",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238000082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF IL",
            "identifier": "01637103",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.