Individual
ERIC SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2750 W NORTH AVE, CHICAGO, IL 60647-5247
(312) 666-3494
Mailing address
3515 N MARSHFIELD AVE APT 2, CHICAGO, IL 60657-1224
(702) 378-0963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.075200
IL
207Q00000X
Family Medicine Physician
Primary
125075200
IL
Other
Enumeration date
03/18/2019
Last updated
08/10/2021
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