Organization
LISA SULLIVAN, MD S.C.
Active
Other names
PANACEA Allergy, Asthma & Immunology
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARIE SULLIVAN (PRESIDENT)
(847) 805-8088
Entity
Organization
Contact information
Practice address
737 SAINT JOHNS AVE, HIGHLAND PARK, IL 60035-4650
(847) 805-8088
(847) 805-8088
Mailing address
19818 CYPRESS BRIDGE DR, ODESSA, FL 33556-4399
(847) 805-8088
(847) 805-8844
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
036107599
IL
Other
Enumeration date
07/16/2008
Last updated
04/24/2025
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