Individual provider Active NPI

Sierra Sorter Donnell, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1912528662
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
72116 Issued in TN
Practice address
1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227
Phone
(312) 942-2200
NPI assigned
May 5, 2020
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125.076098 IL
Pediatrics Physician 208000000X 100363 GA
Pediatrics Physician 208000000X 72116 TN Primary

Addresses

Primary practice location

1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227

Mailing address

1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227
Phone (312) 942-2200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812003394 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1052737723

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100363GAMDPediatrics Physician
125.076098ILMDPediatrics Physician
72116TNMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1912528662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELL",
        "first_name": "SIERRA",
        "middle_name": "SORTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.076098",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "100363",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "72116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.