Sara Jane Fredrickson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036076758 Issued in IL

Practice address

25 N Winfield Rd
Winfield, IL 60190-1295

Phone

(630) 307-7799

Fax

(630) 307-2277

NPI assigned

May 3, 2006

Last updated

Jan 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1922066380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 W Army Trail Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601082674",
            "country_code": "US",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "SARA",
        "middle_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036076758",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "IL",
            "license": "036076758",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076758",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4062703",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (INDIVIDUAL PTAN)",
            "identifier": "206147220",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2215516",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany A Foote, APRN, CNP
• Brian Christopher Fort, M.D.
• Robin R Fortman, APRN, CNP
• Sarah Foulk, DPT
• Michael Anthony Fratina, PA-C
• Jeana L Friday, MHS, MS, BSN, RN-CPN
• Julia Friesen, L.C.S.W.
• Alexandra Ann Frogameni, M.D.
• Andrea Fuller
• Functional Fitness of Dupage, Inc

• Surgery Physician in Winfield, IL
• Providers in Winfield, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.