person
Stacey Lynn Sullivan, CMA
Medical Physician Assistant in Chicago, Illinois
NPI 1891866646

Stacey Lynn Sullivan is a Medical Physician Assistant based in Cicero, IL and is specialized in Medical. Stacey Lynn Sullivan practices in Chicago, IL and has the professional credentials of CMA. The NPI Number for Stacey Lynn Sullivan is 1891866646 and holds a License No. (Illinois).

The current practice location address for Stacey Lynn Sullivan is 1725 W Harrison St, Chicago, IL and can be reached out via phone at 312-997-2229 and via fax at 312-666-4163.

Location: 1725 W Harrison St, Chicago, IL, 60804
person
Provider Profile Details
NPI Number
1891866646
Provider Name
Stacey Lynn Sullivan
Credential
CMA
Provider Entity Type
Individual
Gender
Female
Address
1725 W Harrison St, Chicago, IL, 60804
Phone Number
312-997-2229
Fax Number
312-666-4163
Provider Enumeration Date
11/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1616020 01 IL BC/BS
institution
Provider Business Practice Location Address Details
Address
1725 W Harrison St
City
State
Zip
60612
Phone Number
312-997-2229
Fax Number
312-666-4163
person
Provider Business Mailing Address Details
Address
1725 W Harrison St
City
State
Zip
60612
Phone Number
312-997-2229
Fax Number
312-666-4163
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
()
Definition
Definition to come...
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