Organization
SULLIVAN MEDICAL SQUARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MURRAY MD (OWNER)
(773) 638-2651
Entity
Organization
Contact information
Practice address
15 S KEDZIE AVE, CHICAGO, IL 60612-2705
(773) 638-2651
Mailing address
15 S KEDZIE AVE, CHICAGO, IL 60612-2705
(773) 638-2651
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
03612661
IL
Other
Enumeration date
06/06/2011
Last updated
08/14/2013
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