Provider Demographics
NPI:1922096973
Name:SARTORE, DANNY M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:M
Last Name:SARTORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 SURRY PLACE LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-8109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 W WALNUT ST
Practice Address - Street 2:PASSAVANT AREA HOSPITAL
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-1136
Practice Address - Country:US
Practice Address - Phone:217-245-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079801207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036079801Medicaid
IL08415040OtherBLUE CROSS BLUE SHIELD
IL104409OtherHEALTHLINK GROUP NUMBER
IL32490OtherPERSONAL CARE
IL178809OtherHEALTHLINK UPIN NUMBER
IL085972OtherHEALTH ALLIANCE NUMBER
ILL031806OtherTRICARE
ILE60191Medicare UPIN
IL085972OtherHEALTH ALLIANCE NUMBER
IL779520Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
ILCF2131Medicare ID - Type UnspecifiedMEDICARE RR GROUP NUMBER
ILL031806OtherTRICARE
IL104409OtherHEALTHLINK GROUP NUMBER