Individual
JAMES H SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 GRANT STREET, HARVARD, IL 60033-1821
(815) 943-2693
(815) 943-0659
Mailing address
901 GRANT STREET, HARVARD, IL 60033-1821
(815) 943-2693
(815) 943-0659
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-097083
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891805081
—
WI
01
—
SULLIJAM
MERCYCARE INSURANCE
WI
Enumeration date
08/30/2006
Last updated
04/14/2015
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