Maurice Eugene Sullivan III, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

1209 N Main St
#B
Chatham, IL 62629-0264

Phone

(217) 483-2207

Fax

(217) 483-3248

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sullivan Chiropractic Center P.C.

  dba Sullivan Chiropractic Center

  • Chiropractor
  • Chatham, IL
  • NPI 1891837027
  Medicare reassignment NPD Authorized official
• Jones Chiropractic SC

  • Chiropractor
  • Chatham, IL
  • NPI 1841643368
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649496076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "CHATHAM",
            "state": "IL",
            "postal_code": "626290264",
            "telephone_number": "217-483-2207",
            "fax_number": "217-483-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N MAIN ST",
            "address_2": "#B",
            "city": "CHATHAM",
            "state": "IL",
            "postal_code": "626290264",
            "telephone_number": "217-483-2207",
            "fax_number": "217-483-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MAURICE",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald D Suchomski, M.D.
• Michelle Suess, SLP
• Sullivan Chiropractic Center P.C. (Sullivan Chiropractic Center)
• Christianna Lynn Sullivan, LCSW LCPC
• Kendra Lynn Sullivan, FNP-BC
• John Bryan Taylor, D.C.
• Gina Thomas
• Grace Ann Thomas, PHARMACIST
• Donna Joann Thurston, LCPC
• Time 2 Talk, LLC

• Chiropractor in Chatham, IL
• Providers in Chatham, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.