Sergey Shushunov
MD | Pediatric Critical Care Medicine | Male
Sergey Shushunov, MD is a Highland Park, Illinois based Pediatric doctor with medical specialization in
Pediatric Critical Care Medicine.
Current practice location of Sergey Shushunov is
396 Temple Ave # 396, Highland Park, Illinois - 60035-1435. He can be contacted on phone at
847-432-7830.
Sergey Shushunov is a sole proprietor of his business.
NPI number (Unique professional ID) for Sergey Shushunov is
1588632681 which was assigned by NPPES on 14 Mar, 2006 and it was last updated on 20 Jan, 2023.
Sergey Shushunov license number is
036070073 for Pediatrics, Pediatric Critical Care Medicine (2080P0203X) in Illinois.
Sergey Shushunov is expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Complete Profile:
Sergey Shushunov basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics, Pediatric Critical Care Medicine |
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| Provider Name : | Sergey Shushunov |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Sergey Shushunov address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 396 Temple Ave # 396
Highland Park, IL, 60035-1435
United States |
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| Phone Number : | 847-432-7830 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1588632681 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 14 Mar, 2006 |
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| Last Updated On : | 20 Jan, 2023 |
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Medicare Participation:
Sergey Shushunov participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 0941296800 |
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| Medicare Enrollment ID : | I20221202001917 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | Other |
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| Graduation Year : | 1977 |
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| Accepts Medicare? | Yes. Sergey Shushunov accepts medicare insurance. |
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Group Practice Association:
Sergey Shushunov is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Sergey Shushunov is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| Gateway Express Clinic Pllc | 6901275510 | 2 | 1303 W Algonquin Rd
Lake In The Hills, IL - 601563575
Ph: 3127527226 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Sergey Shushunov are as mentioned. Primary taxonomy code for Sergey Shushunov, MD is
2080P0203X (Pediatrics, Pediatric Critical Care Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | Yes | 036070073 | IL |
| 208000000X | Pediatrics | No | 036070073 | IL |
Legacy Identifiers:
Other legacy medical identifiers of Sergey Shushunov such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 036070073 | MEDICAID | IL | |
| 07215036 | Other (non-Medicare) | IL | BCBS |
| 639810 | MEDICARE ID-Type Unspecified | IL | Medicare |
| E22262 | MEDICARE UPIN | IL | |
| IL0104 | Other (non-Medicare) | IL | John Deere |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 263 Appletree Ct
Buffalo Grove, IL, 60089-2405
United States |
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| Phone Number : | 847-962-1858 |
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Business Location:
Patients can refer following map for directions to
Sergey Shushunov practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.