Active NPI
Susan E. Pearlson, M.D., P.C.
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1629307269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036107647
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL3372 | Other | IL | MEDICARE |
Other names 1
- Susan E. Pearlson, M.D., P.A.
National Provider Directory
National Provider DirectoryNPI 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.