Individual
BRIAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4861 S 27TH ST, GREENFIELD, WI 53221-2603
(414) 325-3325
(414) 325-3334
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4445-024
WI
225100000X
Physical Therapist
Primary
4445-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100045464
—
WI
Enumeration date
02/26/2008
Last updated
07/28/2025
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