Sullivan, Jerry L.

Sullivan, Jerry L. is an sole proprietor health care provider with primary practice located at 3631 S. Sixth Street , Springfield IL 62703. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Sullivan, Jerry L. can be contacted via phone (217) 341-4955.

Contact Information

Primary practice address
3631 S. Sixth Street Springfield IL 62703
Phone: (217) 341-4955
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X Illinois

Profile Details

NPI number 1306909551
LBN Legal business name Sullivan, Jerry L.
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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