Stephanie Sullivan, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125.063484 Issued in IL

Practice address

1304 Franklin Ave
Normal, IL 61761-3558

Phone

(309) 454-1400

NPI assigned

Jun 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Medical College of Wisconsin, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Pekin Memorial Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Pekin, IL
  • NPI 1245355411
  Medicare reassignment NPD
• Saint Francis Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment NPD
• St Mary Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Galesburg, IL
  • NPI 1962467670
  Medicare reassignment NPD
• Advocate Health & Hospitals Corporation

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Pekin Memorial Hospital

  • General Acute Care Hospital
  • Pekin, IL
  • NPI 1245227479
  NPD
• Saint Francis Medical Center

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Peoria, IL
  • NPI 1952351397
  NPD
• St Mary Medical Center

  • Rural Health Clinic/Center
  • Galesburg, IL
  • NPI 1275234965
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• St Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1073952396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-454-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-454-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.063484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Strode, RN
• Keith Studnicki, LPC
• Katherine Marie Stuepfert, MS, CCC-SLP/L
• Gloria L Sugg
• Dodi Suhari, CRNA
• Sulaiman Sultan, M.D.
• Jamie Kaye Summers, DNP, NNP
• Shawna Summers
• Cynthia J. Sutherland, SLP/L
• Susan J Svientek, M.D.

• Emergency Medicine Physician in Normal, IL
• Providers in Normal, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.