Individual
DR. IAN WRIGHT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-5306
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-5306
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036.152223
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2015
Last updated
06/07/2020
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