Individual provider Active NPI

Daniel Jay Schulman, M.D.

  • Pediatrics Physician
  • Sugar Grove, IL
National Provider Identifier
1871507541
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036068021 Issued in IL
Practice address
414 Division Dr
Sugar Grove, IL 60554-5109
Phone
(630) 315-1010
Fax
(630) 315-1005
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036068021 IL Primary

Addresses

Primary practice location

414 Division Dr
Sugar Grove, IL 60554-5109

Mailing address

414 Division Dr
Sugar Grove, IL 60554-5109
Phone (630) 315-1010

Other identifiers 3

IdentifierTypeStateIssuer
036068021MedicaidIL
F400103207OtherILMEDICARE INDIVIDUAL PTAN
920540OtherILMEDICARE GROUP PTAN

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
I20131119001712 IL Practitioner - Pediatric Medicine 9739315813 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Pediatrics CurrentSince Sep 30, 2013 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 30, 2013 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1871507541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 DIVISION DR",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605545109",
            "telephone_number": "630-315-1010",
            "fax_number": "630-315-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 DIVISION DR",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605545109",
            "telephone_number": "630-315-1010",
            "fax_number": "630-315-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULMAN",
        "first_name": "DANIEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036068021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068021",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "F400103207",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "920540",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Grove, IL

Sources for this page

Verify at the official NPI Registry.