Individual
MS. SUSAN M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
307 W GRAND AVE, CHICAGO, IL 60610-4140
(312) 238-6850
Mailing address
3930 N PINE GROVE AVE, #2011, CHICAGO, IL 60613-3346
(773) 477-7063
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
IL
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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