NPIMap

Organization Active NPI

Sullivan Ostoich Eye Care LTD

  • Ophthalmology Physician
  • Hoffman Estates, IL
National Provider Identifier
1598809659
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
060007756 Issued in IL
Legal business name
SULLIVAN OSTOICH EYE CARE LTD
Practice address
1415 Palatine Rd
Hoffman Estates, IL 60192-1196
Phone
(847) 776-8900
Fax
(847) 776-8922
NPI assigned
Feb 20, 2007
Last updated
May 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Kevin L Sullivan, MDNPI 1245390897
Title
Owner Physician
Phone
(847) 776-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 060007756 IL
Ophthalmology Physician 207W00000X 060007756 IL Primary

Addresses

Primary practice location

1415 Palatine Rd
Hoffman Estates, IL 60192-1196

Mailing address

1415 Palatine Rd
Hoffman Estates, IL 60192-1196
Phone (847) 776-8900

Other identifiers 3

IdentifierTypeStateIssuer
1633189OtherILBCBS PROVIDER NUMBER
1598809659MedicaidIL
CH9269OtherILMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713001258 IL Part B Supplier - Clinic/Group Practice 8527046648 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Hoffman Estates, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sullivan Ostoich Eye Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1415 Palatine Rd
Hoffman Estates, IL 60192
Phone (847) 776-8900

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1598809659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 PALATINE RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921196",
            "telephone_number": "847-776-8900",
            "fax_number": "847-776-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PALATINE RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921196",
            "telephone_number": "847-776-8900",
            "fax_number": "847-776-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN OSTOICH EYE CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "847-776-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "060007756",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "060007756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1633189",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598809659",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CH9269",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.