Active NPI
Al U Sango, FNP-BC
- Family Nurse Practitioner
- Lisle, IL
National Provider Identifier
1871039412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.014490
- Practice address
- 420 Walnut Creek LN Unit 3506
Lisle, IL 60532-1946 - Phone
- (708) 364-0580
- NPI assigned
- Jan 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 Nurse Practitioner | 363LF0000X | 209.014490 | IL | Primary |
Addresses
Primary practice location
420 Walnut Creek LN Unit 3506
Lisle, IL 60532-1946
Mailing address
420 Walnut Creek LN Unit 3506
Lisle, IL 60532-1946
Phone (708) 364-0580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553126400000",
"number": "1871039412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 WALNUT CREEK LN UNIT 3506",
"city": "LISLE",
"state": "IL",
"postal_code": "605321946",
"telephone_number": "708-364-0580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 WALNUT CREEK LN UNIT 3506",
"city": "LISLE",
"state": "IL",
"postal_code": "605321946",
"telephone_number": "708-364-0580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANGO",
"first_name": "AL",
"middle_name": "U",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-06",
"last_updated": "2019-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.014490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lisle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.