Sullivan Medical Square, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

03612661 Issued in IL

Legal business name

SULLIVAN MEDICAL SQUARE, INC

Practice address

15 S Kedzie Ave
Chicago, IL 60612-2705

Phone

(773) 638-2651

NPI assigned

Jun 6, 2011

Organization subpart

No

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

Authorized official

Name

Brian Murray, MD

Title

Owner

Phone

(773) 638-2651

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1033403282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122705",
            "telephone_number": "773-638-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122705",
            "telephone_number": "773-638-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN MEDICAL SQUARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-638-2651",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "03612661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zenaida Castro Sulit, R.N.
• Reena Sulkar, MD
• Sheila A Sulkes
• Esther Sulkin, M.S. CCC-SLP
• Jason Paul Sulkowski, MD
• Sullivan Ostoich Eye Care LTD
• Brianne Marie Sullivan
• Bridget Kathleen Sullivan, CRNA
• Caitlin Sullivan
• Cheryl Ann Sullivan, MS, RD, LDN

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.