Individual
SAVANNAH MAE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
333 SKOKIE BLVD STE 108-109, NORTHBROOK, IL 60062-1613
(847) 450-6393
(847) 919-8375
Mailing address
4247 S VALENTINA BAY, SALT LAKE CITY, UT 84107-3394
(937) 360-7940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008952
IL
363A00000X
Physician Assistant
50.007504RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/09/2020
Last updated
09/03/2025
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