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Individual
MS. MARY THERESA O'SULLIVAN
Active
Individual
MS. MARY THERESA O'SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
209007963
IL
284300000X
Special Hospital
209007963
IL
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
209007963
IL
Other
Enumeration date
03/24/2010
Last updated
02/23/2015
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