Individual provider Active NPI

Denise Renee Cunill, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1144233263
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-105752 Issued in IL
Practice address
2840 W Fullerton Ave
Logan Square Health Center of Cook County
Chicago, IL 60647-2938
Phone
(773) 395-2966
Fax
(773) 395-9608
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-105752 IL Primary

Addresses

Primary practice location

2840 W Fullerton Ave
Logan Square Health Center of Cook County
Chicago, IL 60647-2938

Mailing address

2840 W Fullerton Ave
Logan Square Health Center of Cook County
Chicago, IL 60647-2938
Phone (773) 395-2966

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcunill@direct.ccprovider.org Direct Cook County

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000170 IL Practitioner - Pediatric Medicine 6002847134 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-105752ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County Pediatrics CurrentSince Dec 31, 2011 Accepting new patients
Cook County CurrentSince Dec 31, 2011 Accepting new patients

Locations

2840 W Fullerton Ave
Chicago, IL 60647
Phone (773) 395-2631

1900 W Polk St
Bldg 1350
Chicago, IL 60612

2020 W Harrison St
Chicago, IL 60612
Phone (312) 572-4500

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Interoperability endpoints

  • Direct secure messaging: dcunill@direct.ccprovider.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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1144233263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 W FULLERTON AVE",
            "address_2": "LOGAN SQUARE HEALTH CENTER OF COOK COUNTY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472938",
            "telephone_number": "773-395-2966",
            "fax_number": "773-395-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 W FULLERTON AVE",
            "address_2": "LOGAN SQUARE HEALTH CENTER OF COOK COUNTY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472938",
            "telephone_number": "773-395-2966",
            "fax_number": "773-395-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNILL",
        "first_name": "DENISE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-105752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcunill@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.