Individual provider Active NPI

Sanna Margareta Sundquist, M.D.

  • Pediatrics Physician
  • Belleville, IL
National Provider Identifier
1861830358
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-140016 Issued in IL
Practice address
2900 Frank Scott Pkwy W
#950
Belleville, IL 62223-5000
Phone
(618) 233-3205
Fax
(618) 233-1407
NPI assigned
Jun 6, 2013
Last updated
Jul 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 036-140016 IL Primary

Addresses

Primary practice location

2900 Frank Scott Pkwy W
#950
Belleville, IL 62223-5000

Mailing address

2900 Frank Scott Pkwy W
#950
Belleville, IL 62223-5000
Phone (618) 233-3205

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
I20160720000080 IL Practitioner - Pediatric Medicine 9931402716 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-140016ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation, Inc. Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
Southern Illinois Healthcare Foundation Inc Pediatrics Current Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Jul 1, 2016 Accepting new patients

Locations

2900 Frank Scott Pkwy W
Ste 950
Belleville, IL 62223
Phone (618) 233-3205

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

2041 Goose Lake Rd
Sauget, IL 62206

Interoperability endpoints

  • Direct secure messaging: sanna.sundquist.1@9559.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1861830358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 FRANK SCOTT PKWY W",
            "address_2": "#950",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235000",
            "telephone_number": "618-233-3205",
            "fax_number": "618-233-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FRANK SCOTT PKWY W",
            "address_2": "#950",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235000",
            "telephone_number": "618-233-3205",
            "fax_number": "618-233-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDQUIST",
        "first_name": "SANNA",
        "middle_name": "MARGARETA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-140016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.