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DR. JILL ELIZABETH SULLIVAN PH.D.
NPI 1417179409
Psychologist - Cognitive & Behavioral in Chicago, IL

Active since May 02, 2007Opted out of Medicare · through Nov 11, 2027
1 EAST ERIE, SUITE 355, CHICAGO, IL 60611(312) 642-2330 Get Directions Write a Review

NPPES record last updated: June 29, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jill Elizabeth Sullivan Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JILL ELIZABETH SULLIVAN PH.D. (NPI 1417179409) is an individual cognitive & behavioral provider in Chicago, Illinois, licensed in Illinois (071006133) and active in the NPI registry since May 2007. She has opted out of Medicare through November 11, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1417179409
Entity TypeIndividualFemale
Primary Taxonomy103TB0200X
Provider Legal NameDR. JILL ELIZABETH SULLIVANCredential: PH.D.
Location Address1 EAST ERIE, SUITE 355Chicago, IL 60611
Mailing Address1 E Erie St, Suite 355Chicago, IL 60611-2740 · (312) 642-2330
Phone(312) 642-2330
Sole ProprietorYes
Enumeration DateMay 2, 2007
Last NPPES UpdateJune 29, 2009
✔ NPI 1417179409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License✔ Licensed in IL · 071006133
Definition
A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
1 EAST ERIE, SUITE 355, Chicago, IL 60611
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jill Elizabeth Sullivan Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 11, 2015 through November 11, 2027.

Opt-Out Effective DateNovember 11, 2015
Opt-Out In Effect ThroughNovember 11, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jill Sullivan's NPI number?

The NPI number for Jill Sullivan is 1417179409. It was assigned to this individual provider in the NPPES registry on May 2, 2007.

Where is Jill Sullivan located?

Jill Sullivan practices at 1 East Erie, Suite 355, Chicago, IL 60611. The listed phone number is (312) 642-2330.

What is Jill Sullivan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Jill Sullivan enrolled in Medicare?

No. Jill Sullivan has opted out of Medicare through November 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jill Sullivan was last updated on June 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.