JOHN SULLIVAN (MD) – Anesthesiology Physician, NPI 1053337386

JOHN SULLIVAN (MD) is a healthcare provider. based in Chicago, Illinois. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. The NPI Number for JOHN SULLIVAN (MD) is 1053337386

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
JOHN SULLIVAN (MD)
NPI
1053337386
Phone
(312) 695-9797
Address
680 N LAKE SHORE DR
Enumeration Date
13 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7242257000
Graduation Year
2009 (17 years ago)
PAC ID
6608908223
Group Practice PAC ID
2769378751
Professional Enrollment ID
I20180628000010
Address ID
PA153013336WA155XXAVEX307
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:19State licenses:0Digital endpointsOther names

2,633 ANESTHESIOLOGY in IL

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Provider Addresses for JOHN SULLIVAN (MD)

  • 680 North Lake Shore Drive, 680, North Lake Shore Drive, Streeterville, Near North Side, Chicago, Cook County, Illinois, 60611, United States

    SUITE 1000

    CHICAGO, IL 606114546

    Phone: (312) 695-9797

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-06-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180628000010IAnesthesiologyPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60611)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769378751View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)WV
A N E S T H E S I O L O G YPA
Certified Registered Nurse Anesthetist (Crna)PA
A N E S T H E S I O L O G YPA
A N E S T H E S I O L O G YGA
A N E S T H E S I O L O G YMD
Certified Registered Nurse Anesthetist (Crna)NC
A N E S T H E S I O L O G YPA
Certified Registered Nurse Anesthetist (Crna)PA

Reviews

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Frequently asked questions

Can I cross-check JOHN SULLIVAN (MD) using NPI 1053337386?
NPI 1053337386 belongs to JOHN SULLIVAN (MD); compare other details if you need extra assurance.
Is JOHN SULLIVAN (MD) shown as active in public data?
Registry records indicate JOHN SULLIVAN (MD) maintains an active NPI.
What area of care is associated with JOHN SULLIVAN (MD)?
JOHN SULLIVAN (MD)'s record emphasizes Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is JOHN SULLIVAN (MD) registered?
Use Chicago, Illinois as the headline location for JOHN SULLIVAN (MD) here.
When was this NPI issued?
Enumeration for JOHN SULLIVAN (MD) is noted as July 13, 2006 where the registry provides it.

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