Rebecca Sullivan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209022564 Issued in IL

Practice address

390 E Congress Pkwy Ste C
Crystal Lake, IL 60014-6202

Phone

(815) 301-1001

NPI assigned

Jan 20, 2021

Last updated

Jan 24, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nephrology Associates of Northern Illinois LTDGroup PAC ID 2163328675, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
• Saint Joseph Hospital-Elgin Hospital, Elgin, IL, CCN 140217
• Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rsullivan49742@direct.acumenmd.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1124069182
  Medicare reassignment Care Compare group NPD
• Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
  • NPI 1134319924
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Kishwaukee Community Hospital

  dba Northwestern Medicine Kishwaukee Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation
• Rochelle Community Hospital Association

  • Critical Access Hospital
  • Rochelle, IL
  • NPI 1821053216
  Care Compare affiliation
• Saint Joseph Hospital - Elgin LLC

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1922846351
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1689264061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000",
            "fax_number": "630-491-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E CONGRESS PKWY STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146202",
            "telephone_number": "815-301-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4N210 Locust Ave",
            "address_purpose": "LOCATION",
            "city": "West Chicago",
            "state": "IL",
            "postal_code": "601851260",
            "country_code": "US",
            "telephone_number": "630-273-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "endpointDescription": "credentialing@nephdocs.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "credentialing@nephdocs.com",
            "address_1": "390 E Congress Pkwy Ste C",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kellie Stryker, LCSW
• Cheryl Sturtevant, PTA
• Longcheng Su, MD
• Ann C Sullivan
• Karen Sullivan
• Timothy P Sullivan, D.D.S.
• Ann Marie Sumpter, L.C.S.W.
• Xuefan Sun, PHARMD
• Superior Health and Wellness of Crystal Lake, LTD.
• Sean Mark Labastida Superticioso, PT

• Family Nurse Practitioner in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.