Organization
SULLIVAN OSTOICH EYE CARE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L SULLIVAN MD (OWNER PHYSICIAN)
(847) 776-8900
Entity
Organization
Contact information
Practice address
1415 PALATINE RD, HOFFMAN ESTATES, IL 60192-1196
(847) 776-8900
(847) 776-8922
Mailing address
1415 PALATINE RD, HOFFMAN ESTATES, IL 60192-1196
(847) 776-8900
(847) 776-8922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
060007756
IL
207W00000X
Ophthalmology Physician
Primary
060007756
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598809659
—
IL
01
—
1633189
BCBS PROVIDER NUMBER
IL
01
—
CH9269
MEDICARE RAILROAD
IL
Enumeration date
02/20/2007
Last updated
05/10/2022
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