Individual provider Active NPI

Sandra Boafoa Anim, NP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1821422320
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.005388 Issued in IL
Practice address
1715 E 95TH St
Chicago, IL 60617-4708
Phone
(773) 768-4437
Fax
(773) 564-3515
NPI assigned
Sep 3, 2013
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277.005388 IL Primary
Family Health Clinical Nurse Specialist 364SF0001X 041392010 IL

Addresses

Primary practice location

1715 E 95TH St
Chicago, IL 60617-4708

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 768-4437

Other practice location 1

2323 Texas St
Pecos, TX 79772-7338
Phone (432) 447-0565

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
I20241014003470 IL Practitioner - Nurse Practitioner 3577880111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

1715 E 95TH St
Chicago, IL 60617-4708
Phone (312) 733-9730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277.005388ILMDFamily Nurse Practitioner
041392010ILMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Family CurrentSince Oct 21, 2024 Accepting new patients

Locations

1715 E 95th St
Chicago, IL 60617
Phone (773) 768-4437

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1821422320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-768-4437",
            "fax_number": "773-564-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174708",
            "telephone_number": "773-768-4437",
            "fax_number": "773-564-3515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 Texas St",
            "address_purpose": "LOCATION",
            "city": "Pecos",
            "state": "TX",
            "postal_code": "797727338",
            "country_code": "US",
            "telephone_number": "432-447-0565",
            "fax_number": "432-447-0422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANIM",
        "first_name": "SANDRA",
        "middle_name": "BOAFOA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.005388",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "IL",
            "license": "041392010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.