Individual
JESSICCA ANN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4885 HOFFMAN BLVD STE 407, HOFFMAN ESTATES, IL 60192-3726
(224) 484-0183
Mailing address
4885 HOFFMAN BLVD STE 400, HOFFMAN ESTATES, IL 60192-3727
(224) 484-0183
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209024365
IL
363LG0600X
Gerontology Nurse Practitioner
209024365
IL
Other
Enumeration date
03/09/2022
Last updated
08/22/2022
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