Theodore R Sunder
Child Neurologist
421 N 9th St
Springfield
, Illinois 62702-5317
Theodore R Sunder
Child Neurologist
421 N 9th St
Springfield
, Illinois 62702-5317
(217) 757-6869
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About
Features
Specialties
- Child Neurologist
Languages spoken
- English
Location
First Address
- Theodore R Sunder
- 421 N 9th St
- Springfield, IL
- Zip : 62702-5317
- Fax : (217) 757-6869
- Phone : (217) 757-6888
Second Address
- Theodore R Sunder
- 421 N 9th St
- Springfield, IL
- Zip : 62702-5317
- Fax : (217) 757-6869
- Phone : (217) 757-6888
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0402X | Child Neurologist | 036-088538 | IL |
National Provider Identifier
| NPI | 1255315065 |
|---|---|
| Provider Name | Theodore R Sunder |
| First Address | Springfield, IL 62702-5317 |
| Second Address | Springfield, IL 62702-5317 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/12/2005 |
| Last Update Date | 08/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036088538 | (05) | IL |
| C86654 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.