Individual provider Active NPI

Eric Sullivan, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1326507567
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125075200 Issued in IL
Practice address
2750 W North Ave
Chicago, IL 60647-5247
Phone
(312) 666-3494
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.075200 IL
Family Medicine Physician 207Q00000X 125075200 IL Primary

Addresses

Primary practice location

2750 W North Ave
Chicago, IL 60647-5247

Mailing address

3515 N Marshfield Ave Apt 2
Chicago, IL 60657-1224
Phone (702) 378-0963

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
I20220913002645 IL Practitioner - Family Practice 0042544728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

2835 N Sheffield Ave
Suite 104
Chicago, IL 60657-5191
Phone (773) 472-3704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125075200ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Rush University Medical Group Family Medicine CurrentSince Sep 1, 2022 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2835 N Sheffield Ave
Ste 104
Chicago, IL 60657
Phone (312) 876-4577

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1326507567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 N MARSHFIELD AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571224",
            "telephone_number": "702-378-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475247",
            "telephone_number": "312-666-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.075200",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125075200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.