Mary Lynn Sullivan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036077688 Issued in IL

Practice address

5660 W 95TH St
Oak Lawn, IL 60453-2380

Phone

(708) 499-4190

Fax

(708) 857-4427

NPI assigned

Aug 7, 2006

Last updated

Jun 21, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Mary Lynn Sullivan, M.D.P.C.

  • Clinic/Center
  • Oak Lawn, IL
  • NPI 1104074806
  Authorized official Same address or phone
• Advocate Health & Hospitals Corp.

  dba Bethany Hospital

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1750315545
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1437168416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5660 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532380",
            "telephone_number": "708-499-4190",
            "fax_number": "708-857-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5660 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532380",
            "telephone_number": "708-499-4190",
            "fax_number": "708-857-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036077688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077688",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suburban Plastic Surgery, S.C.
• Sudhir M Gokhale MD SC
• Anthony L Sukalo, PHARM D
• Nicholas Sukalski
• Henry James Sullivan, M.D.
• Zachary Sullivan, MD
• Jinglu Sun, M.D.
• Talal Sunbulli, MD
• Kannan Sundar, M.D.
• Sunil K. Shah D.O, S.C

• Internal Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.