Provider Demographics
NPI:1013954999
Name:SUNJE, MENSUR O (MD MSC)
Entity Type:Individual
Prefix:
First Name:MENSUR
Middle Name:O
Last Name:SUNJE
Suffix:
Gender:M
Credentials:MD MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3838
Mailing Address - Country:US
Mailing Address - Phone:773-506-7340
Mailing Address - Fax:773-506-7341
Practice Address - Street 1:2333 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3838
Practice Address - Country:US
Practice Address - Phone:773-506-7340
Practice Address - Fax:773-506-7341
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103665207R00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036103665Medicaid
IL036103665Medicaid
ILH35378Medicare UPIN