Active NPI
Julie J Sundaram, MD
- Emergency Medicine Physician
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 67759-20
- Practice address
- 6500 Excelsior Blvd
Methodist Hospital
St Louis Park, MN 55426 - Phone
- (952) 993-6080
- Fax
- (952) 993-6047
- NPI assigned
- Mar 7, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Internal Medicine) Physician | 207RB0002X | 67759-20 | WI | |
| Emergency Medicine Physician | 207P00000X | 67759-20 | WI | Primary |
| Emergency Medicine Physician | 207P00000X | 45624 | MN | |
| Obesity Medicine (Internal Medicine) Physician | 207RB0002X | 036.106776 | IL | |
| Emergency Medicine Physician | 207P00000X | 036.106776 | IL |
Addresses
Primary practice location
6500 Excelsior Blvd
Methodist Hospital
St Louis Park, MN 55426
Mailing address
5435 Feltl Rd
Minnetonka, MN 55343-7983
Phone (952) 835-9880
Other practice location 1
1000 Mineral Point Ave
Janesville, WI 53548-2982
Phone (608) 756-6611
Other practice location 2
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45624 | Other | MN | MEDICAL LICENSE |
| 108422400 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health System Corporation
Practice addresses (Care Compare)
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45624 | MN | MD | Emergency Medicine Physician |
| 036.106776 | IL | MD | Obesity Medicine (Internal Medicine) Physician |
| 67759-20 | WI | MD | Obesity Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Rockford Health Physicians | Current | Accepting new patients | |
| Mercy Harvard Hospital Inc | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Harvard Hospital Inc | Current | Accepting new patients | |
| Specialists in Medical Imaging, SC | Past | Accepting new patients | |
| Mercy Health System Corporation | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500
1504 S Galena Ave
Dixon, IL 61021
Phone (815) 971-3170
901 Grant St
Harvard, IL 60033
Phone (815) 943-5431
348 S Division St
Harvard, IL 60033
Phone (815) 943-1122
8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
3400 Deerfield Dr
Janesville, WI 53546
Phone (608) 314-3600
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535
Interoperability endpoints
- jsundaram47137@direct.mhemail.org
Organizations & group practices 8
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.
-
- Critical Access Hospital
- Harvard, IL
- NPI 1427001445
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
- Skilled Nursing Facility
- Harvard, IL
- NPI 1124195557
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- Prosthetic/Orthotic Supplier
- Lake Geneva, WI
- NPI 1710124698
-
- Diagnostic Radiology Physician
- Olympia Fields, IL
- NPI 1841687951
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1184691347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5435 FELTL RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553437983",
"telephone_number": "952-835-9880",
"fax_number": "952-857-1554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD",
"address_2": "METHODIST HOSPITAL",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55426",
"telephone_number": "952-993-6080",
"fax_number": "952-993-6047"
}
],
"practiceLocations": [
{
"address_1": "1000 Mineral Point Ave",
"address_purpose": "LOCATION",
"city": "Janesville",
"state": "WI",
"postal_code": "535482982",
"country_code": "US",
"telephone_number": "608-756-6611",
"fax_number": "608-756-6177",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8201 E Riverside Blvd",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611142300",
"country_code": "US",
"telephone_number": "815-971-7000",
"fax_number": "815-968-4795",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUNDARAM",
"first_name": "JULIE",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-07",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RB0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Obesity Medicine",
"state": "WI",
"license": "67759-20",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "67759-20",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "45624",
"primary": false
},
{
"code": "207RB0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Obesity Medicine",
"state": "IL",
"license": "036.106776",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036.106776",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "45624",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108422400",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.