Individual
SULLIVAN WASKOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNM
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3311
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
(217) 383-3311
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209032525
IL
Other
Enumeration date
01/01/2024
Last updated
08/28/2025
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