Active NPI
Thomas Edward Sullivan, DDS
- General Practice Dentistry
- Westchester, IL
National Provider Identifier
1003033283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Practice address
- 1200 High Ridge Parkway
Westchester, IL 60154 - Phone
- (708) 562-4474
- Fax
- (708) 562-4535
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Primary |
Addresses
Primary practice location
1200 High Ridge Parkway
Westchester, IL 60154
Mailing address
9840 Dickens
Westchester, IL 60154
Phone (708) 338-9616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019018114 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS Sullivan & Suchy LTD | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003033283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9840 DICKENS",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "60154",
"telephone_number": "708-338-9616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HIGH RIDGE PARKWAY",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "60154",
"telephone_number": "708-562-4474",
"fax_number": "708-562-4535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westchester, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.