Individual
MR. KEVIN MICHAEL O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/L, CSCS
Contact information
Practice address
120 E. HIGGINS RD, ELK GROVE VILLAGE, IL 60007-3657
(847) 285-4210
Mailing address
448 N STARK DR, PALATINE, IL 60074-3825
(847) 359-8202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096001761
IL
Other
Enumeration date
01/09/2006
Last updated
03/14/2012
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