Active NPI
Madina Sukhanova, PHD
- Clinical Laboratory Director (Non-physician)
- Chicago, IL
National Provider Identifier
1629575972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Laboratory Director (Non-physician)
- License
- 2017203
- Practice address
- 910 S Michigan Ave Apt 1513
Chicago, IL 60605-2288 - Phone
- (630) 846-6501
- NPI assigned
- Apr 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Laboratory Director (Non-physician) | 247ZC0005X | 2017203 | IL | Primary |
Addresses
Primary practice location
910 S Michigan Ave Apt 1513
Chicago, IL 60605-2288
Mailing address
910 S Michigan Ave Apt 1513
Chicago, IL 60605-2288
Phone (630) 846-6501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017203 | IL | MD | Clinical Laboratory Director (Non-physician) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1629575972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 S MICHIGAN AVE APT 1513",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606052288",
"telephone_number": "630-846-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 S MICHIGAN AVE APT 1513",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606052288",
"telephone_number": "630-846-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUKHANOVA",
"first_name": "MADINA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-11",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "247ZC0005X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
"state": "IL",
"license": "2017203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.