Individual
MS. MARY E SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 N COMMONWEALTH AVE, UNIT 2E, CHICAGO, IL 60614-3447
(312) 388-1313
Mailing address
2300 N COMMONWEALTH AVE, UNIT 2E, CHICAGO, IL 60614-3447
(312) 388-1313
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
MS58550810P
IL
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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