Madhupa Sud MD SC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036063319 Issued in IL

Legal business name

MADHUPA SUD MD SC

Practice address

45 W 111TH St
Chicago, IL 60628

Phone

(773) 995-3460

NPI assigned

Nov 18, 2015

Last updated

Nov 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Madhupa Sud, M.D.NPI 1215979729

Title

President

Phone

(773) 995-3460

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Madhupa Sud, M.D.

  • Specialist
  • Chicago, IL
  • NPI 1215979729
  NPD (past) Authorized official

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1063886760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 ASHTON DR",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "60527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60628",
            "telephone_number": "773-995-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADHUPA SUD MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "SUD",
        "authorized_official_first_name": "MADHUPA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-995-3460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036063319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036063319",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rafael Madero Marroquin, MD
• Ashwin Shaan Madhan, MD
• Aatish Madhiwala, M.D.
• Sima M Madhiwala, PHARM.D., BCPS
• Madhu Gundavaram MD SC
• Sally Madiba-Carlson, MD
• Caroline Madigan
• Melanie Lynn Madigan, LCSW
• Komal Usha Chowdary Madineni, MD
• Madison Counseling Solutions LLC (Chicago Counseling And Hypnosis)

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.