# ADDISON PODIATRY CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790351757
- **Authorized official:** DR. JESSICA SULLIVAN DPM (DOCTOR OF PODIATRIC MEDICINE)
- **Authorized official phone:** (630) 205-4557

## Contact information

- **Practice address:** 1250 W LAKE ST, ADDISON, IL 60101-5744
- **Practice address phone:** (630) 543-3000
- **Mailing address:** 198 SUNNYBROOK RD, GLEN ELLYN, IL 60137-6477
- **Mailing address phone:** (630) 205-4557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/01/2021
- **Last updated:** 06/01/2021