Individual
COREY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9945
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9945
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209012309
IL
Other
Enumeration date
01/02/2015
Last updated
11/27/2023
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