Active NPI
Sandra Vera Pavic, DO
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1770528481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 6439 West 63Rd Street
Apt 1C
Chicago, IL 60638-4148 - Phone
- (773) 572-4083
- NPI assigned
- Jun 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
6439 West 63Rd Street
Apt 1C
Chicago, IL 60638-4148
Mailing address
6439 West 63Rd Street
Apt 1C
Chicago, IL 60638-4148
Phone (773) 572-4083
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001622511 | Other | IL | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770528481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6439 WEST 63RD STREET",
"address_2": "APT 1C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606384148",
"telephone_number": "773-572-4083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6439 WEST 63RD STREET",
"address_2": "APT 1C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606384148",
"telephone_number": "773-572-4083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVIC",
"first_name": "SANDRA",
"middle_name": "VERA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0001622511",
"state": "IL"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.