SALLY SALAZAR – Adult Health Nurse Practitioner, NPI 1417664707

SALLY SALAZAR is a healthcare provider. based in Bolingbrook, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209.026133 (IL). The NPI Number for SALLY SALAZAR is 1417664707

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
SALLY SALAZAR
NPI
1417664707
Phone
(630) 506-2068
Address
1497 SOMERFIELD DR
Enumeration Date
4 November 2022
Last Update Date
17 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7732762655
Graduation Year
2022 (4 years ago)
PAC ID
6103297700
Group Practice PAC ID
6800192519
Professional Enrollment ID
I20230118001557
Address ID
IL601814810OA18XXXRDXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for SALLY SALAZAR

  • 1497 SOMERFIELD DR

    BOLINGBROOK, IL 604903207

    Phone: (630) 506-2068

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $130.

Total Amount is formed as General ($130) + Research ($0) + Ownership ($0) = $130.

Last reported payment date: 2023-09-20 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($111).

Total Amount

$130

General + Research + Ownership

Payments

2

Total payment records

General Amount

$130

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-01-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230118001557INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes1,308250$0
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes185184$0
View full utilization report →

Insurance plans in this area (ZIP 60490)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800192519View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
-IL
Nurse PractitionerIL
Internal Medicine, Cardiovascular Disease (Cardiology)FL
-IL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What unique ID ties claims to SALLY SALAZAR?
NPI 1417664707 is assigned to SALLY SALAZAR under the national enumeration system.
Is SALLY SALAZAR active in the national directory?
SALLY SALAZAR's public NPI profile is in an active state.
What does SALLY SALAZAR treat or focus on?
Patients typically see SALLY SALAZAR under the specialty Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is SALLY SALAZAR's primary listing?
We display Bolingbrook, Illinois because that is what the record indicates for SALLY SALAZAR.
How can I contact SALLY SALAZAR?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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