Active NPI
Mary E Sullivan
- Developmental Therapist
- Chicago, IL
National Provider Identifier
1881996288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- MS58550810P
- Practice address
- 2300 N Commonwealth Ave
Unit 2E
Chicago, IL 60614-3447 - Phone
- (312) 388-1313
- NPI assigned
- Nov 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | MS58550810P | IL | Primary |
Addresses
Primary practice location
2300 N Commonwealth Ave
Unit 2E
Chicago, IL 60614-3447
Mailing address
2300 N Commonwealth Ave
Unit 2E
Chicago, IL 60614-3447
Phone (312) 388-1313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MS58550810P | IL | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289952000000",
"number": "1881996288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 N COMMONWEALTH AVE",
"address_2": "UNIT 2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143447",
"telephone_number": "312-388-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 N COMMONWEALTH AVE",
"address_2": "UNIT 2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143447",
"telephone_number": "312-388-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MARY",
"middle_name": "E",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-17",
"last_updated": "2010-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "IL",
"license": "MS58550810P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.