Lisa Marie Sullivan, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

36107599 Issued in IL

Practice address

737 Saint Johns Ave
Highland Park, IL 60035-4650

Phone

(847) 805-8088

Fax

(847) 805-8844

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Lisa Sullivan Professional name

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

Specialty

Allergy/Immunology

Education

University of Florida College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lisa Sullivan, MD S.C.

  dba PANACEA Allergy, Asthma & Immunology

  • Allergy & Immunology Physician
  • Highland Park, IL
  • NPI 1790949980
  Medicare reassignment NPD Authorized official

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

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1386650273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19818 CYPRESS BRIDGE DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335564399",
            "telephone_number": "847-805-8088",
            "fax_number": "847-805-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 SAINT JOHNS AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354650",
            "telephone_number": "847-805-8088",
            "fax_number": "847-805-8844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19818 Cypress Bridge Dr",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "FL",
            "postal_code": "335564399",
            "country_code": "US",
            "telephone_number": "847-805-8088 x101",
            "fax_number": "847-805-8844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "36107599",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "IL",
            "license": "36107599",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "IL",
            "license": "36107599",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "36107599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SULLIVAN",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laura Strohm, PA-C
• Strong Spine Institute, PLLC
• Joseph Strutzel, LMT
• Shweta M Stuart, M.D.
• Edward Suh
• John Sultan
• Sunrise Highland Park Senior Living, LLC (Sunrise of Highland Park)
• Terri L. Sweig, PH.D., ATR-BC, LCPC
• Adriane Lynne Szackamer, PSY.D
• Dustin Szenderski, PT

• Allergy & Immunology Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.

Verify at the official NPI Registry.