Individual
DR. LISA MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
737 SAINT JOHNS AVE, HIGHLAND PARK, IL 60035-4650
(847) 805-8088
(847) 805-8844
Mailing address
19818 CYPRESS BRIDGE DR, ODESSA, FL 33556-4399
(847) 805-8088
(847) 805-8844
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
36107599
IL
207KA0200X
Allergy Physician
36107599
IL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
36107599
IL
2080P0201X
Pediatric Allergy/Immunology Physician
36107599
IL
Other
Enumeration date
07/31/2006
Last updated
04/20/2023
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