Theodore R Sunder, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

036-088538 Issued in IL

Practice address

421 N 9TH St
Springfield, IL 62702-5317

Phone

(217) 757-6888

Fax

(217) 757-6869

NPI assigned

Dec 5, 2005

Last updated

Apr 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1255315065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025317",
            "telephone_number": "217-757-6888",
            "fax_number": "217-757-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025317",
            "telephone_number": "217-757-6888",
            "fax_number": "217-757-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDER",
        "first_name": "THEODORE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IL",
            "license": "036-088538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088538",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Supriya Sullivan
• Sydney J Sullivan, DNP,FNP-BC
• Britanie Lee Sumpter
• Steven David Sumpter, CRNA
• Vidya Sundareshan, MD
• Sunrise Counseling Services LLC
• Terry J Supan, CPO
• Joyce Surbeck-Harris, PHD
• Aparna Suryadevara, MD
• Samuel Susko

• Neurology with Special Qualifications in Child Neurology Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.