Individual
MEGHAN DOEPKE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
1030 N CLARK ST STE 400, CHICAGO, IL 60610-5468
(312) 943-6964
Mailing address
3522 N RACINE AVE, CHICAGO, IL 60657-7890
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209017049
IL
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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