DR. MIRIAM JILL SULLIVAN (NPI# 1851404768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851404768 |
| Entity Type | Individual |
| Full Name | DR. MIRIAM JILL SULLIVAN |
| Other Name | M. JILL SULLIVAN |
| Credential | M.D. |
| Practice Address |
800 E Carpenter St Department of Radiology Springfield IL 62702-5324 |
| Mailing Address |
319 E Madison St Ste 2c Springfield IL 62701-3121 |
| Practice Telephone | 2175446464 |
| Practice Fax Number | 2175255671 |
| Mailing Telephone | 2175442149 |
| Mailing Fax Number | 2175255671 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2009-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036063951 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | P00028347 | 01 |
| IL | RR MEDICARE | 300015701 | 01 |
| IL | 36063951 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740568385 | Miriam Lizette Sullivan | Counselor | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2011-08-01 |
| Street Address |
800 E CARPENTER ST DEPARTMENT OF RADIOLOGY |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-5324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683656 | Mounir F Banoub | Anesthesiology | 800 E Carpenter St, Springfield, IL 62702-5324 | 2005-07-21 |
| 1649897315 | Karen M Stuckey | Registered Nurse | 800 E Carpenter St, Springfield, IL 62769-1000 | 2020-06-29 |
| 1679190581 | Natalie Kay Strope | Registered Nurse | 800 E Carpenter St, Springfield, IL 62769-1000 | 2020-06-26 |
| 1114542404 | Michael J Hohm | Physician Assistant | 800 E Carpenter St, Springfield, IL 62769-1000 | 2020-06-11 |
| 1528681145 | Steven David Sumpter | Nurse Anesthetist, Certified Registered | 800 E Carpenter St, Springfield, IL 62769-1000 | 2020-05-19 |
| 1679193387 | Jennifer Aumann | Nurse Anesthetist, Certified Registered | 800 E Carpenter St, Springfield, IL 62769-1000 | 2020-04-22 |
| 1396365102 | Lauren Aileen Gregory | Registered Nurse | 800 E Carpenter St, Springfield, IL 62769-1000 | 2020-04-22 |
| 1801420559 | Jia Dong | Nurse Anesthetist, Certified Registered | 800 E Carpenter St, Springfield, IL 62769-0002 | 2020-03-02 |
| 1790322469 | Sarah Hoppe | Occupational Therapist | 800 E Carpenter St, Springfield, IL 62769-1000 | 2019-12-02 |
| 1902442411 | Abigail Clark | Speech-Language Pathologist | 800 E Carpenter St, Springfield, IL 62769-1000 | 2019-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1154738961 | Allison Kate Retzer | Radiology | 701 N 1st Box 101, Springfield, IL 62781-0001 | 2014-07-14 |
| 1134552821 | Clinical Radiologists, S.c. | Radiology | 2812 Pat Tillman Dr, Springfield, IL 62711-6410 | 2013-08-16 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| 1316108434 | Michael C Snyder | Radiology | 2201 Greenside Dr, Springfield, IL 62704-3245 | 2008-06-20 |
| 1245416536 | Mary T Peter | Radiology | Springfield Radiologists St Johns Hospital, 800 E. Carpenter Street, Springfield, IL 62769-0001 | 2008-01-16 |
| 1437361060 | Kal Dulaimy | Radiology | 1350 Main Street Suite 1007, Radiology and Imaging, Inc., Springfield, MA 01103-0000 | 2007-05-04 |
| 1265654164 | Nzeadibenma O Uzochukwu | Radiology | 800 Carpenter St, Springfield, IL 62769-0001 | 2007-05-02 |
| 1396865838 | Charles X Stricker | Radiology | 4303 E Lori Lei Ct, Springfield, MO 65809-3501 | 2007-03-29 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.