Individual provider Active NPI

Madhupa Sud, M.D.

  • Specialist
  • Chicago, IL
National Provider Identifier
1215979729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
45 W 111TH St
Suite 203
Chicago, IL 60628-4200
Phone
(773) 995-3460
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

45 W 111TH St
Suite 203
Chicago, IL 60628-4200

Mailing address

192 Ashton Dr
Burr Ridge, IL 60527-0306
Phone (630) 325-1177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036063319ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Roseland Community Hospital Association Current Accepting new patients
Madhupa Sud MD SC Past Accepting new patients

Locations

45 W 111th St
Chicago, IL 60628
Phone (773) 995-3000

45 W 111th St
Ste 203
Chicago, IL 60628
Phone (773) 995-3460

Interoperability endpoints

  • Direct secure messaging: msud@roselandhospital.medalliesdirect.net

Organizations & group practices 2

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215979729",
    "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": "605270306",
            "telephone_number": "630-325-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUD",
        "first_name": "MADHUPA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.