Active NPI
Corlyne Sue Mulder, M.D.
- Otolaryngology Physician
- Aurora, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036.134838
- Practice address
- 1221 N Highland Ave
Aurora, IL 60506-1404 - Phone
- (630) 859-8700
- NPI assigned
- Jun 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Otolaryngology Physician | 207Y00000X | 036.134838 | IL | Primary |
Addresses
Primary practice location
1221 N Highland Ave
Aurora, IL 60506-1404
Mailing address
2357 Sequoia Dr
Aurora, IL 60506-6222
Phone (630) 859-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036134838 | Medicaid | IL |
Other names 1
- Dr. Corlyne Sue Liebenthal
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cmulder207110@direct.myadvocateaurora.org | ||
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Michigan College of Medicine and Surgery, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 N Highland Ave
Aurora, IL 60506-1404
Phone (630) 859-6800
Hospital & facility affiliations
- Advocate Good Samaritan Hospital
- Copley Memorial Hospital
- Advocate Sherman Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 56 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.134838 | IL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Past | Accepting new patients |
Locations
2357 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700
1221 N Highland Ave
Aurora, IL 60506
Phone (630) 859-6700
28594 Network Pl
Chicago, IL 60673
1508 Aurora Ave
Naperville, IL 60540
Phone (630) 585-7100
Interoperability endpoints
- cmulder207110@direct.myadvocateaurora.org
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Aurora, IL
- NPI 1003542184
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Downers Grove, IL
- NPI 1578670543
-
- General Acute Care Hospital
- Elgin, IL
- NPI 1629026364
-
- General Acute Care Hospital
- Aurora, IL
- NPI 1295882561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1124254602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2357 SEQUOIA DR",
"city": "AURORA",
"state": "IL",
"postal_code": "605066222",
"telephone_number": "630-859-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 N HIGHLAND AVE",
"city": "AURORA",
"state": "IL",
"postal_code": "605061404",
"telephone_number": "630-859-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULDER",
"first_name": "CORLYNE",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2021-11-18",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036.134838",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036134838",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cmulder207110@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "1221 N Highland Ave",
"city": "Aurora",
"state": "IL",
"country_code": "US",
"postal_code": "605061404",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1221 N Highland Ave",
"city": "Aurora",
"state": "IL",
"country_code": "US",
"postal_code": "605061404",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "CORLYNE",
"last_name": "LIEBENTHAL",
"middle_name": "SUE",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.