Sullivan, Jerry
Sullivan, Jerry is an individual health care provider with primary practice located at 1975 Lin Lor Ln , Elgin IL 60123-4902. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Sullivan, Jerry can be contacted via phone (847) 468-6098.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 070-002636 | Illinois |
Profile Details
| NPI number | 1487631594 |
|---|---|
| LBN Legal business name | Sullivan, Jerry |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Oct 25th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487631594 | NPPES |
| Other | 753210 | MEDICARE GROUP | |
| Other | CF2064 | MEDICARE GROUP | |
| Other | 070002636 | MEDICARE GROUP |
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