Individual
MR. JARED JOHN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 990-5261
Mailing address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 990-5261
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
03/26/2024
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