Individual provider Active NPI

Kari A Sullivan

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1043606445
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209012429 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(888) 824-0200
NPI assigned
Apr 13, 2015
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209012429 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksullivan188285@uchospital.direct-ci.com University of Chicago Physicians Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150721000001 IL Practitioner - Nurse Practitioner 0244543247 Reassigns benefits to 2 organizations
I20181203000723 IN Practitioner - Nurse Practitioner 0244543247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians
Rci (WRS) LLCGroup PAC ID 5092624510, shared by 17 NPIs, 325 clinicians

Practice addresses (Care Compare)

10855 Virginia St
Suite 2100
Crown Point, IN 46307-0210
Phone (888) 824-0200

1300 Lincolnway
Valparaiso, IN 46383-5824

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209012429ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Mar 26, 2020 Accepting new patients
The University of Chicago Medical Center CurrentSince Mar 26, 2020 Accepting new patients
Associates in Medical Oncology CurrentSince Mar 19, 2015 Accepting new patients
University of Chicago CurrentSince Mar 26, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

19060 Everett Blvd
Unit 112
Mokena, IL 60448
Phone (708) 346-4040

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

4400 W 95th St
Ste 311
Oak Lawn, IL 60453

4440 W 95th St
Ste 31W
Oak Lawn, IL 60453
Phone (708) 684-5475

10855 Virginia St
Ste 2100
Crown Point, IN 46307
Phone (219) 407-5540

10855 Virginia St
Ste 2200
Crown Point, IN 46307
Phone (219) 407-5540

1500 S Lake Park Ave
Ste 109
Hobart, IN 46342
Phone (219) 942-0551

Interoperability endpoints

  • Direct secure messaging: kari.sullivan@affiliatedoncologists.ikm.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1043606445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR",
            "address_2": "SUITE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "888-824-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KARI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209012429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksullivan188285@uchospital.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "University of Chicago Physicians Group",
            "address_1": "5841 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.