Individual provider Active NPI

Sijo Thomas Sunny

  • Internal Medicine Physician
  • Danville, IL
National Provider Identifier
1508489543
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036164397 Issued in IL
Practice address
108 Robinson St
Danville, IL 61832-8515
Phone
(217) 443-0146
NPI assigned
May 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036164397 IL Primary

Addresses

Primary practice location

108 Robinson St
Danville, IL 61832-8515

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 443-0146

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
I20230807000883 IL Practitioner - Internal Medicine 0244657260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

108 Robinson St
Danville, IL 61832-8515
Phone (217) 442-8611

Hospital & facility affiliations

  • Carle Home Care Home health agency, Champaign, IL, CCN 147241
  • Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036164397ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC Internal Medicine CurrentSince Jul 3, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

108 Robinson St
Danville, IL 61832
Phone (217) 442-8611

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: ssunnymd375494@carlehiedirect.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.

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1508489543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-443-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ROBINSON ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618328515",
            "telephone_number": "217-443-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNNY",
        "first_name": "SIJO",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036164397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.