SARA WALL (NPI# 1558878439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558878439 |
| Entity Type | Individual |
| Full Name | SARA WALL |
| Credential | NURSE PRACTITIONER |
| Practice Address |
5537 N Broadway St Chicago IL 60640-1405 |
| Mailing Address |
4025 N Sheridan Rd Chicago IL 60613-2010 |
| Practice Telephone | 7733881600 |
| Practice Fax Number | 7733881602 |
| Mailing Telephone | 7733881600 |
| Mailing Fax Number | 7733881602 |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.016835 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PENDING | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1525 E 55th St, Chicago, IL 606155512 | 7733881600 | 7733881602 |
| 2800 N Sheridan Rd Ste 211, Chicago, IL 606576161 | 7733881600 | 7734727499 |
| 3245 N Halsted St, Chicago, IL 606573419 | 7733881600 | 7732968401 |
| 4025 N Sheridan Rd, Chicago, IL 606132010 | 7733881600 | 7733881602 |
| 641 W 63rd St, Chicago, IL 606212032 | 7733881600 | 7733881602 |
| 6500 N Clark St, Chicago, IL 606264097 | 7733881600 | 7735644156 |
| 734 W 47th St, Chicago, IL 606094411 | 7733881600 | 7733881602 |
| Street Address |
5537 N BROADWAY ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-1405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952480287 | Access Community Health Network | Clinic/Center | 5537 N Broadway St, Chicago, IL 60640-1405 | 2006-11-06 |
| 1568007433 | Christina Joly | Counselor | 5537 N Broadway St, Chicago, IL 60640-1405 | 2019-11-14 |
| 1356876387 | Howard Brown Health Center | Clinic/Center | 5537 N Broadway St, Ste 101, Chicago, IL 60640-1405 | 2017-04-27 |
| 1831464510 | Julie A Supple | Social Worker | 5537 N Broadway St, Chicago, IL 60640-1405 | 2012-03-14 |
| 1568737252 | Charlotte J Moore | Counselor | 5537 N Broadway St, Chicago, IL 60640-1405 | 2012-03-14 |
| 1699040378 | Paul K Wiemerslage | Social Worker | 5537 N Broadway St, Chicago, IL 60640-1405 | 2012-03-14 |
| 1750656435 | Thomas F Holler | Counselor | 5537 N Broadway St, Chicago, IL 60640-1405 | 2012-03-14 |
| 1538434212 | Dayna L Flores | Counselor | 5537 N Broadway St, Chicago, IL 60640-1405 | 2012-03-14 |
| 1174896914 | Tpa Network Incorporated | Counselor | 5537 N Broadway St, Chicago, IL 60640-1405 | 2012-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.