Search › Illinois › 2255A2300X
Jerry Sullivan, ATC
NPI 1306909551 · on the registry since 2006 · sole proprietor
Practice
- Address
- 3631 S. Sixth Street
Springfield, IL 62703 - Phone
- (217) 341-4955
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois