Individual provider Active NPI

Christopher J. Sullivan, MD

  • Cardiovascular Disease Physician
  • Hazel Crest, IL
National Provider Identifier
1770506271
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036093913 Issued in IL
Practice address
17850 Kedzie Ave Ste 3250
Hazel Crest, IL 60429-2082
Phone
(708) 779-8700
Fax
(708) 957-1830
NPI assigned
Jul 25, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036093913 IL Primary

Addresses

Primary practice location

17850 Kedzie Ave Ste 3250
Hazel Crest, IL 60429-2082

Mailing address

17850 Kedzie Ave Ste 3250
Hazel Crest, IL 60429-2082
Phone (708) 779-8700

Other identifiers 1

IdentifierTypeStateIssuer
036093913MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address csullivan206151@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070419000376 IL Practitioner - Cardiovascular Disease (Cardiology) 6305941360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11800 Southwest Hwy
Palos Heights, IL 60463-1065
Phone (708) 952-7444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036093913ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 10, 2017 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

28592 Network Pl
Chicago, IL 60673

29373 Network Pl
Chicago, IL 60673

17850 Kedzie Ave
Ste 3250
Hazel Crest, IL 60429
Phone (708) 779-8700

11600 S Kedzie Ave
Ste D
Merrionette Park, IL 60803
Phone (708) 389-2200

4440 W 95th St
Ste Aip
Oak Lawn, IL 60453
Phone (708) 684-8000

11800 Southwest Hwy
Palos Heights, IL 60463
Phone (708) 361-0220

Interoperability endpoints

  • Direct secure messaging: csullivan206151@direct.myadvocateaurora.org

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1770506271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE STE 3250",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292082",
            "telephone_number": "708-779-8700",
            "fax_number": "708-957-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE STE 3250",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292082",
            "telephone_number": "708-779-8700",
            "fax_number": "708-957-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036093913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093913",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csullivan206151@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17850 Kedzie Ave Ste 3250",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17850 Kedzie Ave Ste 3250",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

Verify at the official NPI Registry.