Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1942868658 Individual Practitioner Female Practitioner

Supriya Sullivan

Surgery • Springfield, IL

Professional Overview & Biography Verified Profile Summary

Supriya Sullivan is a registered healthcare professional specializing in Surgery in Springfield, IL. Practice services are available at 701 N 1ST ST STE D308 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

701 N 1st St Ste D308

Springfield, IL 627023757

Telephone 2175454401
Fax 2175451793

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Springfield, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.2 Yrs
State Avg: 27.3 Yrs
Regional Practice Density
55 Specialists

Practicing in Springfield, IL (1624 Statewide)

Telehealth Adoption Rate
3.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-05-04
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IL 125074249

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License IA MD-64865

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Secondary Practice Locations

200 Hawkins Dr

Iowa City, IA 522421009

Phone: 3193537227

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

31 Associated Practitioners
NPI 1043625270

Doctor of Medicine (M.D.)

Wendy Lim

Surgery

NPI 1063037851
NPI 1083407803

Doctor of Medicine (M.D.)

NPI 1154618775

Doctor of Medicine (M.D.)

NPI 1215595582

Doctor of Medicine (M.D.)

NPI 1235978776

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 04, 2025

Surgery (License #MD-64865 in IA)

👤
Provider Name / Credentials Updated August 11, 2022

Recorded as SUPRIYA SULLIVAN

NPI Profile Active May 29, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location May 29, 2019

Registered at 701 N 1ST ST STE D308, SPRINGFIELD, IL 627023757 (Tel: 2175454401)

📍
Updated Business Mailing Address May 29, 2019

Registered at PO BOX 19638, SPRINGFIELD, IL 627949638

👤
Provider Name / Credentials Updated May 29, 2019

Recorded as SUPRIYA SHAH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2019

Surgery (License #125074249 in IL)

🟢
Initial NPI Registration & Enumeration May 29, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1942868658
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 29, 2019
Last Update: May 04, 2025
Sole Proprietor: No

Mailing Address

Po Box 19638

Springfield, IL 627949638

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.