MICHELLE JACKSON SUMRALL (MD) – Pediatrics Physician, NPI 1639158520
Pediatrics Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MICHELLE JACKSON SUMRALL (MD)
Music Box Theatre, 3733, North Southport Avenue, Wrigleyville, Lake View, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60613, United States
CHICAGO, IL 606776351
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
Ring Road, Elizabethtown, Hardin County, Kentucky, 42701, United States
ELIZABETHTOWN, KY 427018968
Phone: (270) 765-2107
Fax: (270) 169-9642
Type: Location
PO BOX 776879
CHICAGO, IL 606776879
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
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: 2005-01-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050118000561 | I | Pediatric Medicine | KY | TBD |
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.
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 60677)
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