THEODORE R SUNDER M.D. NPI 1255315065

NPI Information

NPI: 1255315065
Provider Name: THEODORE R SUNDER, M.D.
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

Address:
421 N 9TH ST
SPRINGFIELD, IL
ZIP 62702
Phone: (217) 757-6888
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Theodore R Sunder, M.D. is a neurology with special qualifications in child neurology psychiatry neurology in Springfield, IL. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. Theodore R Sunder, M.D. NPI is 1255315065. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

421 N 9TH ST
SPRINGFIELD, IL
ZIP 62702-317
Phone: (217) 757-6888
Fax: (217) 757-6869

The enumeration date for this NPI number is 12/5/2005 and was last updated on 4/8/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	036-088538	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	L82254	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
2	036088538	MEDICAID	ILLINOIS
3	C86654	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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