Individual
DOMINIQUE ANGELA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, DT
Contact information
Practice address
140 E LOOP RD, WHEATON, IL 60189-8407
(312) 243-8487
Mailing address
2901 FINLEY RD STE 102, DOWNERS GROVE, IL 60515-1774
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
10/09/2024
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