Individual
MS. CHERYL A SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
707 N LOGAN AVE, DANVILLE POLYCLINIC, LTD., DANVILLE, IL 61832-4360
(217) 477-4784
(217) 477-4704
Mailing address
707 N LOGAN AVE, DANVILLE POLYCLINIC, LTD., DANVILLE, IL 61832-4360
(217) 477-4784
(217) 477-4704
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209008516
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201080250
—
IN
Enumeration date
01/20/2011
Last updated
01/12/2015
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