Healthcare Provider Details

I. General information

NPI: 1013954999
Provider Name (Legal Business Name): MENSUR O. SUNJE M.D. M.SC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 W IRVING PARK RD
CHICAGO IL
60618-3838
US

IV. Provider business mailing address

2333 W IRVING PARK RD
CHICAGO IL
60618-3838
US

V. Phone/Fax

Practice location:
  • Phone: 773-506-7340
  • Fax: 773-506-7341
Mailing address:
  • Phone: 773-506-7340
  • Fax: 773-506-7341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036103665
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number036103665
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: