Individual provider Active NPI

Janine Rose Sulavik

  • Physician Assistant
  • Dyer, IN
National Provider Identifier
1881220994
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007718 Issued in IL
Practice address
275 Joliet St
Dyer, IN 46311-1776
Phone
(219) 865-8800
NPI assigned
Mar 20, 2020
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 085007718 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

275 Joliet St
Dyer, IN 46311-1776

Mailing address

5141 Virginia Way Ste 350
Brentwood, TN 37027-2319
Phone (615) 449-5771

Other practice location 1

103 N Haven Rd Ste 7
Elmhurst, IL 60126-2973
Phone (630) 832-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210325001723 IN Practitioner - Physician Assistant 7416364161 Reassigns benefits to 1 organization
I20241031002933 IL Practitioner - Physician Assistant 7416364161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Washington University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

1124 Essington Rd
Suite a
Joliet, IL 60435-8442
Phone (815) 744-8554

2500 S Highland Ave
Suite 320
Lombard, IL 60148-5390
Phone (815) 744-8554

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085007718ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Multi-Specialty CurrentSince Dec 1, 2024 Accepting new patients
Dermatology and Plastic Surgery Associates, S.C. Multi-Specialty PastSince Apr 3, 2017 Accepting new patients
Athens Medical Group, Inc Multi-Specialty Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: janine.sulavik@qdp.emadirect.md
  • Direct secure messaging: jsulavik@pinnacleskin.emadirect.md

Organizations & group practices 5

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1881220994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 VIRGINIA WAY STE 350",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272319",
            "telephone_number": "615-449-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111776",
            "telephone_number": "219-865-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 N Haven Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601262973",
            "country_code": "US",
            "telephone_number": "630-832-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULAVIK",
        "first_name": "JANINE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007718",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.