Organization Active NPI

Susan E. Pearlson, M.D., P.C.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1629307269
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036107647 Issued in IL
Legal business name
SUSAN E. PEARLSON, M.D., P.C.
Practice address
645 N Michigan Ave
Suite 803
Chicago, IL 60611-2826
Phone
(773) 531-3427
NPI assigned
Dec 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Dr. Susan E. Pearlson, M.D.
Title
President
Phone
(773) 531-3427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036107647 IL Primary

Addresses

Primary practice location

645 N Michigan Ave
Suite 803
Chicago, IL 60611-2826

Mailing address

645 N Michigan Ave
Suite 803
Chicago, IL 60611-2826
Phone (773) 531-3427

Other identifiers 1

IdentifierTypeStateIssuer
IL3372OtherILMEDICARE

Other names 1

  • Susan E. Pearlson, M.D., P.A. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1629307269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MICHIGAN AVE",
            "address_2": "SUITE 803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112826",
            "telephone_number": "773-531-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N MICHIGAN AVE",
            "address_2": "SUITE 803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112826",
            "telephone_number": "773-531-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN E. PEARLSON, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "PEARLSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-531-3427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036107647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IL3372",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan E. Pearlson, M.D., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.