Individual
EMMA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1127 N OAKLEY BLVD, CHICAGO, IL 60622-3507
(312) 770-2317
Mailing address
1127 N OAKLEY BLVD, CHICAGO, IL 60622-3507
(312) 770-2317
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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